Individual
JAMES ROBERT MITSOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
10759 WINTERSET DR, ORLAND PARK, IL 60467-1106
(708) 580-0404
Mailing address
10759 WINTERSET DR, ORLAND PARK, IL 60467-1106
(708) 580-0404
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019031336
IL
1223G0001X
General Practice Dentistry
33277
TX
Other
Enumeration date
07/13/2017
Last updated
10/05/2020
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