| Ivory Dental Specialist Llc | |
|
1040 E 47th Street Chicago IL 60653 | |
| (773) 239-7696 | |
| Not Available |
| Full Name | Ivory Dental Specialist Llc |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 1040 E 47th Street, Chicago, Illinois |
| Authorized Official Name and Position | Bonciel Griffin (ORTHODONTIST/OWNER) |
| Authorized Official Contact | 7732397696 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ivory Dental Specialist Llc 1040 E 47th St Chicago IL 60653-3600 Ph: (773) 924-5123 | Ivory Dental Specialist Llc 1040 E 47th Street Chicago IL 60653 Ph: (773) 239-7696 |
| NPI Number | 1417384793 |
|---|---|
| Provider Enumeration Date | 10/02/2013 |
| Last Update Date | 10/02/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417384793 | NPI | - | NPPES |
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