Individual
JAY A WYGODNY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD PC
Contact information
Practice address
2592 E GRAND AVE STE 102, LINDENHURST, IL 60046-5915
(847) 265-4420
(847) 265-4429
Mailing address
2592 E GRAND AVE STE 102, LINDENHURST, IL 60046-5915
(847) 265-4420
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-019212
IL
Other
Enumeration date
06/12/2007
Last updated
04/05/2021
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