Jerry Brooks D.D.S.

NPI 1669592259 - Dentist - 1223G0001X

NPI Details
NPI 1669592259
Gender Male
Enumeration Date 03/29/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
2655 W PETERSON AVE
CHICAGO IL, 60659-4017, US
Phone (773) 769-3334
Fax
Business Location
2655 W PETERSON AVE
CHICAGO IL, 60659-4017, US
Phone (773) 769-3334
Fax
Toxanomy
Taxonomy Code 1223G0001X
License State Illinois
License Number 19A14020
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According to our database, Dr. Jerry Brooks D.D.S. NPI is 1669592259, taxonomy code is 1223G0001X and license number is 19A14020, license state is located at Illinois. Jerry Brooks D.D.S. physically located at 2655 W Peterson Ave, Chicago IL, 60659-4017. NPI Number Jerry Brooks D.D.S. has the Individual type.

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1669592259 NPI number is provided on an as is basis without warranty of any kind. 1669592259 is maintained by the National Plan & Provider Enumeration System. The contents of Jerry Brooks D.D.S. are for informational purposes only.