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801 S Paulina St Mc 621 Chicago IL 60612-7210 | |
| (312) 996-7555 | |
| (312) 355-3864 |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 801 S Paulina St, Chicago, Illinois |
| Authorized Official Name and Position | David M Clark (ASSOCIATE DEAN FOR PATIENT SERVICES) |
| Authorized Official Contact | 3129963544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
801 S Paulina St Mc 621 Chicago IL 60612-7210 Ph: (312) 996-7555 | 801 S Paulina St Mc 621 Chicago IL 60612-7210 Ph: (312) 996-7555 |
| NPI Number | 1992873921 |
|---|---|
| Provider Enumeration Date | 11/30/2006 |
| Last Update Date | 12/12/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992873921 | NPI | - | NPPES |
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