Organization
JAIRO H PATINO DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAIRO H PATINO DDS (PRESIDENT)
(312) 405-1040
Entity
Organization
Contact information
Practice address
3190 N ELSTON AVE, CHICAGO, IL 60618-5845
(773) 267-9777
Mailing address
1130 S MICHIGAN AVE APT 1809, CHICAGO, IL 60605-2319
(312) 405-1040
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
—
IL
Other
Enumeration date
03/30/2008
Last updated
03/30/2008
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