| Alia Ezziddin D.m.d., P.c. | |
|
711 11th St Wilmette IL 60091-2671 | |
| (847) 906-8676 | |
| Not Available |
| Full Name | Alia Ezziddin D.m.d., P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 711 11th St, Wilmette, Illinois |
| Authorized Official Name and Position | Alia Ezziddin (DENTIST/OWNER/PRESIDENT) |
| Authorized Official Contact | 8479068676 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Alia Ezziddin D.m.d., P.c. 711 11th St Wilmette IL 60091-2671 Ph: (847) 906-8676 | Alia Ezziddin D.m.d., P.c. 711 11th St Wilmette IL 60091-2671 Ph: (847) 906-8676 |
| NPI Number | 1649419623 |
|---|---|
| Provider Enumeration Date | 02/13/2009 |
| Last Update Date | 06/24/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649419623 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019027203 (Illinois) | Primary |
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