Zidron, Martin J

Zidron, Martin J is an individual health care provider with primary practice located at 21660 W Field Pkwy Suite 220, Deer Park IL 60010-7265. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Pathology, which is considered as his primary health care specialty. Zidron, Martin J can be contacted via phone (847) 381-0106.

Contact Information

Primary practice address
21660 W Field Pkwy Suite 220 Deer Park IL 60010-7265
Phone: (847) 381-0106
Fax: (847) 381-0265
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Pathology 1223P0106X 019-017572 Illinois

Profile Details

NPI number 1164462362
LBN Legal business name Zidron, Martin J
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Jul 24th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164462362 NPPES
Illinois Other 80002564 BCBS PROVIDER NUMBER
Illinois Other 80022564 BCBS PROVIDER NUMBER

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