| John Petrucci Dds | |
|
328 E Army Trail Rd Glendale Hts IL 60139 | |
| (630) 924-5579 | |
| Not Available |
| Full Name | John Petrucci Dds |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 328 E Army Trail Rd, Glendale Hts, Illinois |
| Authorized Official Name and Position | John Petrucci (OWNER) |
| Authorized Official Contact | 6309245579 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Petrucci Dds 328 E Army Trail Rd Glendale Hts IL 60139 Ph: (630) 924-5579 | John Petrucci Dds 328 E Army Trail Rd Glendale Hts IL 60139 Ph: (630) 924-5579 |
| NPI Number | 1346407335 |
|---|---|
| Provider Enumeration Date | 05/19/2008 |
| Last Update Date | 05/19/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346407335 | NPI | - | NPPES |
| 019019714 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019019714 (Illinois) | Primary |