Organization
RUSSELL J. CECALA, D.D.S., M.S., LTD DBA PERIOCARE
Active
Other names
PerioCare
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL J. CECALA D.D.S.,M.S. (PRESIDENT/OWNER)
(773) 631-0344
Entity
Organization
Contact information
Practice address
7447 W TALCOTT AVE, SUITE 227, CHICAGO, IL 60631-3745
(773) 631-0344
(773) 631-0211
Mailing address
7447 W TALCOTT AVE, SUITE 227, CHICAGO, IL 60631-3745
(773) 631-0344
(773) 631-0211
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
IL
Other
Enumeration date
03/27/2007
Last updated
12/22/2014
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