Organization
JAY A WYGODNY DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAY A WYGODNY DMD (OWNER)
(847) 265-4420
Entity
Organization
Contact information
Practice address
2592 E GRAND AVE STE 102, LINDENHURST, IL 60046-5915
(847) 265-4420
(847) 265-4429
Mailing address
2592 E GRAND AVE STE 102, LINDENHURST, IL 60046-5915
(847) 265-4420
(847) 265-4429
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
02/18/2020
Last updated
08/14/2020
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