Organization
MARIETTA A BUFALINO INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIETTA A BUFALINO DDS (PRESIDENT)
(847) 397-6060
Entity
Organization
Contact information
Practice address
4005 1 2 ALGONQUIN RD, ROLLING MEADOWS, IL 60008
(847) 397-6060
(847) 397-6063
Mailing address
4005 1 2 ALGONQUIN RD, ROLLING MEADOWS, IL 60008
(847) 397-6060
(847) 397-6063
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019019069
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019019069
STATE LICENSE
IL
Enumeration date
01/18/2007
Last updated
01/12/2011
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