Individual
DR. IVANDARIO SALDARRIAGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
3440 OHIO ST, GREAT LAKES, IL 60088-3155
(919) 699-5628
Mailing address
3440 OHIO ST, GREAT LAKES, IL 60088-3155
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.032017
IL
122300000X
Dentist
33287
TX
Other
Enumeration date
08/22/2017
Last updated
07/26/2021
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