George Michael Dieck, D.D.S. Valid NPI

Individual provider · General Practice Dentistry · Waukegan, IL

NPI

1962624643

Type

Individual (Type 1)

Primary specialty

General Practice Dentistry (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223G0001X

License number

19A12473 (IL)

Sex

Male

Sole proprietor

No

Enumerated

2007-05-03

Last updated

2007-07-08