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Organization

GREGORY V. SIERMINSKI, D.D.S., P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GREGORY VALENTINE SIERMINSKI D.D.S (DENTIST)
(815) 728-0100
Entity
Organization

Contact information

Practice address
7442 HANCOCK DRIVE, CRYSTAL LAKE, IL 60097
(815) 728-0100
(815) 728-0114
Mailing address
P.O. BOX 388, WONDER LAKE, IL 60097
(815) 728-0100
(815) 728-0114

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1003734
IL
05
101265
IL
Enumeration date
03/14/2008
Last updated
03/14/2008
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