Individual
DR. MARK LAWRENCE VITALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
101 E COLE AVE, WHEATON, IL 60187-3105
(630) 668-0100
Mailing address
101 E COLE AVE, WHEATON, IL 60187-3105
(630) 668-0100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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