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General NPI Number Information
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NPI Number | 1114482791
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Entity Type | Organization
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Legal Business Name | JOHN J MROZEK DDS, PC
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Dates
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Enumeration Date | 02/07/2019
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Last Update Date | 02/07/2019
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Provider Practice Location Address
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Address Line | 7017 W ARCHER AVE
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City | CHICAGO
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State | IL
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Zip | 60638-2201
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Country | US
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Telephone | 773-229-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 7017 W ARCHER AVE
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City | CHICAGO
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State | IL
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Zip | 60638-2201
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Country | US
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Telephone | 773-229-1050
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN JOSEPH MROZEK
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Credential | DDS
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Telephone | 773-229-1050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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