Individual
DAVID JOEL REISBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
811 S. PAULINA ST., MC 588, CHICAGO, IL 60612-4305
(312) 996-6933
(312) 355-4173
Mailing address
811 S. PAULINA ST., MC 588, CHICAGO, IL 60612-4305
(312) 996-6933
(312) 355-4173
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
019017383
IL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
019-017383
IL
Other
Enumeration date
10/25/2006
Last updated
12/09/2019
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