Individual provider · Type 1 NPI

Jason C. Primavera, DDS

Oral and Maxillofacial Surgery (Dentist) · Chicago, IL

NPI number 1831487370 Active

Practice location

1901 W Harrison St
Chicago, IL 60612-3714

Mailing address

6050 Brynwood Dr
Rockford, IL 61114-6579

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X018001817 (IL)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

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About NPI 1831487370

Jason C. Primavera, DDS's National Provider Identifier is 1831487370, issued on Jul 19, 2011. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Chicago, IL. The record was last updated on Aug 24, 2015.