Individual
GEORGE D DI TOLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3521 W LAKE ST, MELROSE PARK, IL 60160
(708) 865-1214
(708) 865-7933
Mailing address
3521 W LAKE ST, MELROSE PARK, IL 60160
(708) 865-1214
(708) 865-7933
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0190162026
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
101670
—
IL
Enumeration date
05/20/2008
Last updated
05/20/2008
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