Organization
SOUTHWEST ENDODONTICS
Active
Other names
Orland Endodontics
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VLADIMIR TISMENSKY DDS (PRESIDENT)
(708) 576-8442
Entity
Organization
Contact information
Practice address
16055 108TH AVE, STE H, ORLAND PARK, IL 60467-5347
(708) 460-9191
(708) 460-9407
Mailing address
16055 108TH AVE, STE H, ORLAND PARK, IL 60467-5347
(708) 460-9191
(709) 460-9407
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
02101135
IL
Other
Enumeration date
01/13/2010
Last updated
05/28/2021
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