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Individual

DR. LISA ANN CIUCCI O'GRADY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
1216 N DIVISION ST, MORRIS, IL 60450
(815) 941-4343
(815) 942-8414
Mailing address
1216 N DIVISION ST, MORRIS, IL 60450
(815) 941-4343
(815) 942-8414

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019023659
IL

Other

Enumeration date
11/07/2007
Last updated
08/04/2008
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