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Organization

MICHAEL A. ESPOSITO DDS, P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL A ESPOSITO DDS (OWNER)
(708) 544-9773
Entity
Organization

Contact information

Practice address
5646 SAINT CHARLES RD, SUITE C, BERKELEY, IL 60163-1148
(708) 544-9773
Mailing address
5646 SAINT CHARLES RD, SUITE C, BERKELEY, IL 60163-1148
(708) 544-9773

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-019100
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019-019100
STATE DENTAL LICENSE
IL
Enumeration date
06/24/2016
Last updated
06/24/2016
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