NPI 1164604740

Dimitra Petrakos, RDH

Practitioner Dental Hygienist Evergreen Park, IL

Practice location

Address: 2803 W 95th St, Evergreen Park, IL 60805-2702
Phone: (708) 425-1134
Fax: (708) 423-3779

Registered specialties

Dental Hygienist Primary

Dental Providers Taxonomy 124Q00000X

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Registry record

NPI: 1164604740
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Dec 2007
Record last updated: 5 Dec 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.