Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | IL | |
N | 1223P0300X | Periodontist | IL |
NPI | 1073687927 |
---|---|
Provider Name | Dr. John A. Saniat |
First Address | Wheaton, IL 60187-5463 |
Second Address | Wheaton, IL 60187-5463 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/11/2006 |
Last Update Date | 08/07/2007 |