Individual
DR. MICHAEL ROBERT MITSOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
310 RIDGE RD, MUNSTER, IN 46321-1528
(219) 836-8200
Mailing address
8148 VALLEY VIEW CT, TINLEY PARK, IL 60477-4519
(312) 953-2352
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13005015A
IN
Other
Enumeration date
01/23/2007
Last updated
07/08/2007
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