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Individual

DR. MICHAEL S STOSICH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD,MS

Contact information

Practice address
1275 E BELVIDERE RD, SUITE 100, GRAYSLAKE, IL 60030-2082
(847) 548-4200
(847) 548-4527
Mailing address
1275 E BELVIDERE RD, SUITE 100, GRAYSLAKE, IL 60030-2082

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019.028558
IL

Other

Enumeration date
09/14/2011
Last updated
03/17/2018
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