Individual
DR. ANDREW THOMAS BRACCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
3001 6TH ST, GREAT LAKES, IL 60088-2833
(847) 688-2100
Mailing address
1212 N LASALLE ST, UNIT 1105, CHICAGO, IL 60610-8027
(312) 502-1292
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
19026285
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
055288
NY
Other
Enumeration date
01/09/2006
Last updated
04/09/2024
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