Individual
JOHN MICALETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
115 55TH ST, SUITE 201, CLARENDON HILLS, IL 60514-1593
(630) 789-0900
(630) 789-3861
Mailing address
115 55TH ST, SUITE 201, CLARENDON HILLS, IL 60514-1593
(630) 789-0900
(630) 789-3861
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
IL
Other
Enumeration date
04/20/2007
Last updated
07/08/2007
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