JOSEPH CANZONA DDS MD LTD NPI 1104099324

NPI Information

JOSEPH CANZONA DDS MD LTD is a medical specialty clinic center in Evanston, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer). JOSEPH CANZONA DDS MD LTD NPI is 1104099324. The provider is registered as an organization entity type.

The provider's business location address is:

2500 RIDGE AVENUE
SUITE 302
EVANSTON, IL
ZIP 60201-477
Phone: (847) 328-8899
Fax: (847) 328-3545

The provider's authorized official is Joseph E Canzona .
The authorized official title is Owner and has the following contact phone number (847) 328-8899.

The enumeration date for this NPI number is 4/9/2008 and was last updated on 5/22/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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