Organization
FRED J. MARCHESE DDS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FRED J. MARCHESE D.D.S. (OWNER)
(708) 343-6065
Entity
Organization
Contact information
Practice address
1440 W NORTH AVE, SUITE 304, MELROSE PARK, IL 60160-1422
(708) 343-6065
(708) 343-6287
Mailing address
1440 W NORTH AVE, SUITE 304, MELROSE PARK, IL 60160-1422
(708) 343-6065
(708) 343-6287
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019019113
IL
Other
Enumeration date
01/10/2012
Last updated
01/10/2012
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