Di Tola, George D

Di Tola, George D is an sole proprietor health care provider with primary practice located at 3521 W Lake St , Melrose Park IL 60160. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Di Tola, George D can be contacted via phone (708) 865-1214.

Contact Information

Primary practice address
3521 W Lake St Melrose Park IL 60160
Phone: (708) 865-1214
Fax: (708) 865-7933
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 0190162026 Illinois

Profile Details

NPI number 1770740565
LBN Legal business name Di Tola, George D
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 20th, 2008
Last updated May 20th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770740565 NPPES
Illinois MEDICAID 101670

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