Provider Demographics
NPI:1194945667
Name:TESTA, REBECCA J (DDS)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:J
Last Name:TESTA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:19815 GOVERNORS HWY
Mailing Address - Street 2:SUITE # 4
Mailing Address - City:FLOSSMOOR
Mailing Address - State:IL
Mailing Address - Zip Code:60422-4385
Mailing Address - Country:US
Mailing Address - Phone:708-814-5783
Mailing Address - Fax:
Practice Address - Street 1:19815 GOVERNORS HWY
Practice Address - Street 2:SUITE # 4
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60422-4385
Practice Address - Country:US
Practice Address - Phone:708-814-5783
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2013-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190273731223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry