Individual
DR. AMY MARIE DUSTOOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MS
Contact information
Practice address
1921 W NORTH AVE, CHICAGO, IL 60622-1351
(773) 276-0335
Mailing address
1921 W NORTH AVE, CHICAGO, IL 60622-1351
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019029369
IL
Other
Enumeration date
07/26/2013
Last updated
10/24/2013
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