Organization
JOHN G. IFANTIS, DDS, PC
Active
Other names
Ifantis Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN IFANTIS DDS (OFFICE MANAGER)
(847) 663-0003
Entity
Organization
Contact information
Practice address
9251 WAUKEGAN RD, MORTON GROVE, IL 60053-2102
(847) 663-0003
(847) 663-0390
Mailing address
9251 WAUKEGAN RD, MORTON GROVE, IL 60053-2102
(847) 663-0003
(847) 663-0390
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019024881
—
IL
Enumeration date
10/12/2016
Last updated
10/12/2016
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