Provider Demographics
NPI:1548303084
Name:DUZINSKAS-RICORDATI, DAWN MARIE (DDS)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:MARIE
Last Name:DUZINSKAS-RICORDATI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:360 SHERWOOD RD
Mailing Address - Street 2:
Mailing Address - City:LA GRANGE PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60526-1967
Mailing Address - Country:US
Mailing Address - Phone:708-352-4470
Mailing Address - Fax:708-354-7371
Practice Address - Street 1:360 SHERWOOD RD
Practice Address - Street 2:
Practice Address - City:LA GRANGE PARK
Practice Address - State:IL
Practice Address - Zip Code:60526-1967
Practice Address - Country:US
Practice Address - Phone:708-352-4470
Practice Address - Fax:708-354-7371
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist