Individual
DR. ALBERT A. DIEPSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
342 SHERWOOD RD, LA GRANGE PARK, IL 60526-1967
(708) 482-4610
Mailing address
342 SHERWOOD RD, LA GRANGE PARK, IL 60526-1967
(708) 482-4610
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19A15115
IL
Other
Enumeration date
05/12/2008
Last updated
05/12/2008
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