Midwest Family Dental, LLC

NPI #1508268053 in Waukegan, Illinois

Provider Information

NPI Number: 1508268053
Entity Type: Organization
Organization Name: Midwest Family Dental, LLC
Primary Specialty: Dentist
Enumeration Date: Sep 16, 2014
Last Updated: Sep 16, 2014

Practice Location

Address: 916 N GREEN BAY RD
City: Waukegan
State: Illinois
ZIP Code: 60085-2240
Phone: (773) 267-8600

Authorized Official

Name: DR. RANDOLPH CHANG, DDS
Title: MEMBER
Phone: (773) 267-8600

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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