University Dental Professionals

NPI 1548484793 - Dentist - 122300000X

NPI Details
NPI 1548484793
Enumeration Date 04/12/2007
Last Updated 07/22/2008
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name MARY BETH MARY BETH
Position OFFICE MANAGER
Phone (773) 684-5702
Fax
Practice Location
5549 S CORNELL AVE
CHICAGO IL, 60637-1914, US
Phone (773) 684-5702
Fax
Business Location
5549 S CORNELL AVE
CHICAGO IL, 60637-1914, US
Phone (773) 684-5702
Fax (773) 684-5493
Toxanomy
Taxonomy Code 122300000X
License State Illinois
License Number 019026856
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According to our database, University Dental Professionals NPI is 1548484793, taxonomy code is 122300000X and license number is 019026856, license state is located at Illinois. University Dental Professionals physically located at 5549 S Cornell Ave, Chicago IL, 60637-1914. NPI Number 1033115704 has the healthcare provider type.

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1548484793 NPI number is provided on an as is basis without warranty of any kind. 1548484793 is maintained by the National Plan & Provider Enumeration System. The contents of University Dental Professionals are for informational purposes only.