Organization
VALLEY CREEK FAMILY DENTAL LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK MICHAEL MITSOS DMD (PRESIDENT)
(708) 429-9699
Entity
Organization
Contact information
Practice address
16653 80TH AVE, TINLEY PARK, IL 60477
(708) 429-9699
Mailing address
16653 80TH AVE, TINLEY PARK, IL 60477-1215
(708) 429-9699
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019029811
IL
Other
Enumeration date
07/26/2017
Last updated
08/24/2017
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