Provider Demographics
NPI:1255414264
Name:JANZEN, MARITA K (DDS MS)
Entity type:Individual
Prefix:DR
First Name:MARITA
Middle Name:K
Last Name:JANZEN
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Gender:F
Credentials:DDS MS
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Mailing Address - Street 1:1220 MEADOW RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-9998
Mailing Address - Country:US
Mailing Address - Phone:847-272-0600
Mailing Address - Fax:847-272-1094
Practice Address - Street 1:1220 MEADOW RD
Practice Address - Street 2:SUITE 300
Practice Address - City:NORTHBROOK
Practice Address - State:IL
Practice Address - Zip Code:60062-9998
Practice Address - Country:US
Practice Address - Phone:847-272-0600
Practice Address - Fax:847-272-1094
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
IL1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics