M & R Dental, Pllc

NPI #1558080283 in Evanston, Illinois

Provider Information

NPI Number: 1558080283
Entity Type: Organization
Organization Name: M & R Dental, Pllc
Primary Specialty: Dentist - General Practice
Enumeration Date: Aug 25, 2022
Last Updated: Aug 25, 2022

Practice Location

Address: 1560 SHERMAN AVE STE 902
City: Evanston
State: Illinois
ZIP Code: 60201-4809
Phone: (847) 864-8151

Authorized Official

Name: MS. COLEEN-SHANNON LICAR
Title: MANAGER
Phone: (847) 864-8151

Specialties & Taxonomy Codes

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

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