Individual
JOHN PERISIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
516 E MAIN ST, ST CHARLES, IL 60174-2133
(630) 377-3131
Mailing address
106 E HANOVER PL, PEORIA, IL 61614-2120
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.032202
IL
Other
Enumeration date
06/24/2019
Last updated
07/06/2023
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