Dr. John Dimoulis, DDS MS
Dentist, Periodontics in Chicago, IL. Individual provider (NPI-1).
NPI number1962592865
StatusActive
Last updated in NPPESJul 8, 2007
Details
- NPI
- 1962592865
- Entity type
- Individual (NPI-1)
- Name
- Dr. John Dimoulis
- Credential
- DDS MS
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Oct 13, 2006
- Last updated
- Jul 8, 2007
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223P0300X | Dentist, Periodontics | 019-019721 | IL | Yes |
Practice location
5780 N Lincoln AveChicago, IL 60659-4721
Phone 773-769-1754 · Fax 773-769-1350
Mailing address
5780 N Lincoln AveChicago, IL 60659-4721
Phone 773-769-1754 · Fax 773-769-1350
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All 76 Periodontics providers in Chicago · All 81,422 providers in Chicago
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