Organization
GEORGE D DI TOLA DDS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE DOMINICK DITOLA DDS (BUSINESS OWNER)
(708) 865-1214
Entity
Organization
Contact information
Practice address
3521 W LAKE ST, MELROSE PARK, IL 60160-2825
(708) 865-1214
(708) 865-7933
Mailing address
3521 W LAKE ST, MELROSE PARK, IL 60160-2825
(708) 865-1214
(708) 865-7933
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019016202G
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1001668
—
IL
Enumeration date
11/09/2005
Last updated
06/16/2008
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