Provider Demographics
NPI:1972876696
Name:MACIEJAUSKAS-WATERS, RAMUNE R (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAMUNE
Middle Name:R
Last Name:MACIEJAUSKAS-WATERS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9356 S ROBERTS RD
Mailing Address - Street 2:
Mailing Address - City:HICKORY HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60457-2168
Mailing Address - Country:US
Mailing Address - Phone:708-598-2131
Mailing Address - Fax:
Practice Address - Street 1:9356 S ROBERTS RD
Practice Address - Street 2:
Practice Address - City:HICKORY HILLS
Practice Address - State:IL
Practice Address - Zip Code:60457-2168
Practice Address - Country:US
Practice Address - Phone:708-598-2131
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-10
Last Update Date:2012-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-0186481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice