| Organization Name: | JAMES G. LOESER, DDS, MD, PC |
| NPI Number: | 1073849139 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JAMES G LOESER (CEO) |
| Mailing Address: | 1580 N Northwest Hwy #300 Park Ridge |
| State: | IL US |
| Postal Code: | 600681444 |
| Phone Number: | 8473908200 |
| Fax Number: | 8473908200 |
| NPI Enumeration Date: | 10/26/2009 |
| NPI Last Update Date: | 10/26/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 204E00000X |
| License Number: | 036121553 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Oral & Maxillofacial Surgery |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |