Provider Demographics
NPI:1730303520
Name:TAGLIA, JR, LOUIS F (DDS)
Entity Type:Individual
Prefix:
First Name:LOUIS
Middle Name:F
Last Name:TAGLIA, JR
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7310 W NORTH AVE
Mailing Address - Street 2:SUITE 4A
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-4252
Mailing Address - Country:US
Mailing Address - Phone:708-456-1188
Mailing Address - Fax:708-456-9369
Practice Address - Street 1:7310 W NORTH AVE
Practice Address - Street 2:SUITE 4A
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-4252
Practice Address - Country:US
Practice Address - Phone:708-456-1188
Practice Address - Fax:708-456-9369
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice