Organization
ALIA EZZIDDIN D.M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALIA EZZIDDIN DMD (DENTIST/OWNER/PRESIDENT)
(847) 906-8676
Entity
Organization
Contact information
Practice address
711 11TH ST, WILMETTE, IL 60091-2671
(847) 906-8676
Mailing address
711 11TH ST, WILMETTE, IL 60091-2671
(847) 906-8676
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019027203
IL
Other
Enumeration date
02/13/2009
Last updated
06/24/2016
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