Provider Demographics
NPI:1194986240
Name:OSAN-TOPALA, MARIA (DDS)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:OSAN-TOPALA
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:PO BOX 5214
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:IL
Mailing Address - Zip Code:60438-5214
Mailing Address - Country:US
Mailing Address - Phone:708-895-0724
Mailing Address - Fax:708-895-0757
Practice Address - Street 1:2457 RIDGE RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:IL
Practice Address - Zip Code:60438-2711
Practice Address - Country:US
Practice Address - Phone:708-895-0724
Practice Address - Fax:708-895-0757
Is Sole Proprietor?:No
Enumeration Date:2008-06-21
Last Update Date:2008-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-015507122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist