Organization
J.V. DISCIPIO, D.D.S. & ASSOC., LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES LAWRENCE DISCIPIO D.D.S., M.S. (PRESIDENT-OWNER)
(708) 749-0133
Entity
Organization
Contact information
Practice address
6737 STANLEY AVE, BERWYN, IL 60402-3129
(708) 749-0133
(708) 749-7778
Mailing address
6737 STANLEY AVE, BERWYN, IL 60402-3129
(708) 749-0133
(708) 749-7778
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19A-10123
IL
1223G0001X
General Practice Dentistry
19A19017
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
$$$$$$$$$
SOCIAL SECURITY NUMBER
IL
Enumeration date
11/27/2006
Last updated
08/22/2020
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