Provider Demographics
NPI:1144586231
Name:THEODOSIS, FRANCISKA SOULA (DMD)
Entity Type:Individual
Prefix:MRS
First Name:FRANCISKA
Middle Name:SOULA
Last Name:THEODOSIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3233 N ARLINGTON HEIGHTS RD STE 308
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1507
Mailing Address - Country:US
Mailing Address - Phone:847-253-5800
Mailing Address - Fax:847-253-7035
Practice Address - Street 1:3233 N ARLINGTON HEIGHTS RD STE 308
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1507
Practice Address - Country:US
Practice Address - Phone:847-253-5800
Practice Address - Fax:847-253-7035
Is Sole Proprietor?:No
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019024090122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist