Provider Demographics
NPI:1487735338
Name:ZANONI, JOHN S (DDS)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:S
Last Name:ZANONI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:140 N LA GRANGE RD
Mailing Address - Street 2:SUITE 14
Mailing Address - City:LA GRANGE
Mailing Address - State:IL
Mailing Address - Zip Code:60525-2046
Mailing Address - Country:US
Mailing Address - Phone:708-352-1650
Mailing Address - Fax:708-352-2975
Practice Address - Street 1:140 N LA GRANGE RD
Practice Address - Street 2:SUITE 14
Practice Address - City:LA GRANGE
Practice Address - State:IL
Practice Address - Zip Code:60525-2046
Practice Address - Country:US
Practice Address - Phone:708-352-1650
Practice Address - Fax:708-352-2975
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics