Praire Shores Dental

NPI #1033281225 in Chicago, Illinois

Provider Information

NPI Number: 1033281225
Entity Type: Organization
Organization Name: Praire Shores Dental
Primary Specialty: Dentist - General Practice
Enumeration Date: Nov 14, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 2525 S MICHIGAN AVE
Address 2: 8TH FL
City: Chicago
State: Illinois
ZIP Code: 60616-2333
Phone: (312) 567-2299

Authorized Official

Name: VICKIE WELCH
Title: OFFICE COORDINATOR
Phone: (312) 567-2299

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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