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General NPI Number Information
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NPI Number | 1376740316
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Entity Type | Organization
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Legal Business Name | PATRICK A SPILOTRO DDS PC
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Dates
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Enumeration Date | 07/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2604 E DEMPSTER ST LANDINGS PROFESSIONAL CENTER SUITE 202
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City | PARK RIDGE
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State | IL
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Zip | 60068
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Country | US
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Telephone | 847-299-0557
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Fax | 547-299-0561
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Provider Business Mailing Address
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Address Line | 2604 E DEMPSTER ST LANDINGS PROFESSIONAL CENTER SUITE 202
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City | PARK RIDGE
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State | IL
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Zip | 60068
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Country | US
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Telephone | 847-299-0557
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Fax | 547-299-0561
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Authorized Official
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Title or Position | OWNER PRES
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Name | DR. PATRICK A SPILOTRO SR.
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Credential | DDS
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Telephone | 847-299-0557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | IL
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