Provider Demographics
NPI:1760463772
Name:DEMEROS, GEORGE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:A
Last Name:DEMEROS
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:PO BOX 3742
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60011-3742
Mailing Address - Country:US
Mailing Address - Phone:312-968-0802
Mailing Address - Fax:847-842-1462
Practice Address - Street 1:5400 N MILWAUKEE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60630-1272
Practice Address - Country:US
Practice Address - Phone:847-508-0101
Practice Address - Fax:847-842-1463
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice