Individual
DR. ANTONIO STAVROS GANIOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5700 DEMPSTER ST, MORTON GROVE, IL 60053-3040
(847) 965-6223
Mailing address
5700 DEMPSTER ST, MORTON GROVE, IL 60053-3040
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.034004
IL
1223G0001X
General Practice Dentistry
30.025804
OH
Other
Enumeration date
06/17/2019
Last updated
01/19/2023
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