Organization
SOUTH PARK ORTHODONTICS LTD
Active
Other names
DiFranco Orthodontics
Organization subpart
No
Provider details
NPI number
Authorized official
FAITH GASKINS (DIRECTOR OF CREDENTIALING)
(972) 869-3789
Entity
Organization
Contact information
Practice address
401 W TALCOTT RD STE 5408, PARK RIDGE, IL 60068-5408
(847) 318-7711
Mailing address
401 W TALCOTT RD STE 5408, PARK RIDGE, IL 60068-5408
(847) 318-7711
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
11/24/2020
Last updated
11/24/2020
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