Organization
ILLIANA ENDODONTICS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL JOHN MINTZ DDS (PRESIDENT)
(708) 755-2021
Entity
Organization
Contact information
Practice address
934 RICHARD RD, DYER, IN 46311-1936
(219) 865-9790
(708) 755-2027
Mailing address
934 RICHARD RD, DYER, IN 46311-1936
(219) 865-9790
(708) 755-2027
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
021001405
IL
1223E0200X
Endodontics
Primary
—
IL
Other
Enumeration date
11/16/2006
Last updated
04/24/2026
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