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Organization

ILLINOIS VALLEY ENDODONTICS LLC

Active
Other names
Lee M. Ceresa DDS
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEE MICHAEL CERESA DDS (OWNER/DENTIST)
(815) 224-3636
Entity
Organization

Contact information

Practice address
1601 4TH ST, PERU, IL 61354-3507
(815) 224-3636
(815) 220-1479
Mailing address
1601 4TH ST, PERU, IL 61354-3507
(815) 224-3636
(815) 220-1479

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
IL

Other

Enumeration date
01/09/2008
Last updated
01/09/2008
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