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NPI Code Detail

MEDICARE: TRICIA ANN LETRERO WORIAX DDS

MEDICARE: TRICIA ANN LETRERO WORIAX DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1285783951
Entity Type Code : Individual
Provider Name (Legal Business Name) : TRICIA ANN LETRERO WORIAX DDS
Provider Business Mailing Address
First Line : 430 W ERIE ST STE 500
Second Line :
City : CHICAGO
State : IL
Zip : 60610-4032
Country : US
Telephone Number : 920-838-1649
Fax Number :
Provider Business Practice Location Address
First Line : 4039 W NORTH AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60639-5219
Country : US
Telephone Number : 773-782-4800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2007
Last Update Date : 07/08/2007

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Directions to “ TRICIA ANN LETRERO WORIAX DDS” Practice Location

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