Individual
JOSEPH DAW JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, DDS
Contact information
Practice address
550 E DEVON AVE STE 200, ITASCA, IL 60143-2639
(864) 625-3376
Mailing address
550 E DEVON AVE STE 200, ITASCA, IL 60143-2639
(864) 625-3376
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
019020141
IL
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
036097545
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036097545
—
IL
Enumeration date
02/22/2006
Last updated
05/27/2019
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