Provider Demographics
NPI:1972877744
Name:LETIZIA HEADACHE SOLUTIONS LLC
Entity type:Organization
Organization Name:LETIZIA HEADACHE SOLUTIONS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:DENNIS
Authorized Official - Last Name:LETIZIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-494-9970
Mailing Address - Street 1:303 E ARMY TRAIL RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-2169
Mailing Address - Country:US
Mailing Address - Phone:630-494-9970
Mailing Address - Fax:630-529-8636
Practice Address - Street 1:303 E ARMY TRAIL RD
Practice Address - Street 2:
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-2169
Practice Address - Country:US
Practice Address - Phone:630-494-9970
Practice Address - Fax:630-529-8636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-26
Last Update Date:2012-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019017569122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty