| Craig Kostrubala Dds Llc | |
|
11107 S Lawler Ave Alsip IL 60803-6038 | |
| (708) 346-9600 | |
| Not Available |
| Full Name | Craig Kostrubala Dds Llc |
|---|---|
| Speciality | Dentist |
| Location | 11107 S Lawler Ave, Alsip, Illinois |
| Authorized Official Name and Position | Craig Kostrubala (OWNER) |
| Authorized Official Contact | 7083469600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Craig Kostrubala Dds Llc 11107 S Lawler Ave Alsip IL 60803-6038 Ph: (708) 346-9600 | Craig Kostrubala Dds Llc 11107 S Lawler Ave Alsip IL 60803-6038 Ph: (708) 346-9600 |
| NPI Number | 1548651110 |
|---|---|
| Provider Enumeration Date | 02/18/2015 |
| Last Update Date | 02/18/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548651110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019023283 (Illinois) | Primary |
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