| Aqua Dental Of Chicago | |
|
2346 W Cermak Rd Chicago IL 60608-3812 | |
| (773) 579-9480 | |
| (773) 579-9481 |
| Full Name | Aqua Dental Of Chicago |
|---|---|
| Speciality | Dentist |
| Location | 2346 W Cermak Rd, Chicago, Illinois |
| Authorized Official Name and Position | Dai-hong Kim (PRESIDENT) |
| Authorized Official Contact | 3475348088 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aqua Dental Of Chicago 2346 W Cermak Rd Chicago IL 60608-3812 Ph: (773) 579-9480 | Aqua Dental Of Chicago 2346 W Cermak Rd Chicago IL 60608-3812 Ph: (773) 579-9480 |
| NPI Number | 1700194776 |
|---|---|
| Provider Enumeration Date | 09/23/2010 |
| Last Update Date | 09/23/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700194776 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019027018 (Illinois) | Primary |
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