Dr. Dimitri Theodore Tsoukalas, D.D.S.
Dentist, General Practice in Orland Park, IL. Individual provider (NPI-1).
NPI number1861695983
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1861695983
- Entity type
- Individual (NPI-1)
- Name
- Dr. Dimitri Theodore Tsoukalas
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 6, 2007
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 019015918 | IL | Yes |
Practice location
14624 John Humphrey DrOrland Park, IL 60462-2642
Phone 708-349-6606
Mailing address
14624 John Humphrey DrOrland Park, IL 60462-2642
Phone 708-349-6606
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