| Advanced Endodontics, Pc | |
|
103 S. Greenleaf Street Suite K Gurnee IL 60031 | |
| (847) 782-0048 | |
| (847) 782-0102 |
| Full Name | Advanced Endodontics, Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 103 S. Greenleaf Street, Gurnee, Illinois |
| Authorized Official Name and Position | John E Stuparitz (PRESIDENT OWNER DDS) |
| Authorized Official Contact | 8478407580 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Advanced Endodontics, Pc 921 Old Trail Rd Higland Park IL 60035 Ph: (847) 782-0048 | Advanced Endodontics, Pc 103 S. Greenleaf Street Suite K Gurnee IL 60031 Ph: (847) 782-0048 |
| NPI Number | 1588163364 |
|---|---|
| Provider Enumeration Date | 02/07/2018 |
| Last Update Date | 02/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588163364 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 021.001771 (Illinois) | Secondary |
| 1223G0001X | Dentist - General Practice | 019.020999 (Illinois) | Primary |
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