Organization
ADVANCED ENDODONTICS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN E STUPARITZ DDS, MS (PRESIDENT OWNER DDS)
(847) 840-7580
Entity
Organization
Contact information
Practice address
103 S. GREENLEAF STREET, SUITE K, GURNEE, IL 60031
(847) 782-0048
(847) 782-0102
Mailing address
921 OLD TRAIL RD, HIGLAND PARK, IL 60035
(847) 782-0048
(847) 782-0102
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
021.001771
IL
1223G0001X
General Practice Dentistry
Primary
019.020999
IL
Other
Enumeration date
02/07/2018
Last updated
02/07/2018
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