Individual
DR. JUSTIN TYLER DURANCIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
619 E MAIN ST, GENOA, IL 60135-1309
(815) 784-5166
Mailing address
16488 E MCNEAL RD, MONROE CENTER, IL 61052-9719
(815) 761-7159
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.031786
IL
Other
Enumeration date
09/20/2018
Last updated
09/20/2018
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