Organization
ORAL FACIAL & IMPLANT SPECIALISTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARTIN JAMES ZIDRON D.D.S. (PRESIDENT)
(847) 381-0106
Entity
Organization
Contact information
Practice address
21660 W FIELD PKWY, SUITE 220, DEER PARK, IL 60010-7265
(847) 381-0106
(847) 381-0265
Mailing address
21660 W FIELD PKWY, SUITE 220, DEER PARK, IL 60010-7265
(847) 381-0106
(847) 381-0265
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
060001824
IL
Other
Enumeration date
05/25/2007
Last updated
07/24/2012
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