Jerry Joseph Lebeda JR. DDS

NPI 1609922863 - Dentist - 122300000X

NPI Details
NPI 1609922863
Gender Male
Enumeration Date 01/28/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
19 HERITAGE DR
SUITE 207
BOURBONNAIS IL, 60914-1369, US
Phone (815) 933-3479
Fax (815) 933-8698
Business Location
19 HERITAGE DR
SUITE 207
BOURBONNAIS IL, 60914-1369, US
Phone (815) 933-3479
Fax (815) 933-8698
Toxanomy
Taxonomy Code 122300000X
License State
License Number
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According to our database, Dr. Jerry Joseph Lebeda JR. DDS NPI is 1609922863, taxonomy code is 122300000X Jerry Joseph Lebeda JR. DDS physically located at 19 Heritage Dr, Bourbonnais IL, 60914-1369. NPI Number Jerry Joseph Lebeda JR. DDS has the Individual type.

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1609922863 NPI number is provided on an as is basis without warranty of any kind. 1609922863 is maintained by the National Plan & Provider Enumeration System. The contents of Jerry Joseph Lebeda JR. DDS are for informational purposes only.