Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | IL | |
N | 204E00000X | Oral & Maxillofacial Surgeon | 190-24119 | IL |
NPI | 1548375710 |
---|---|
Provider Name | Dr. Helene M Dolce |
First Address | Libertyville, IL 60048-5233 |
Second Address | Libertyville, IL 60048-5233 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 08/07/2007 |