Demp Fern Mg Dental Corp.
NPI #1649602632 in Morton Grove, Illinois
Provider Information
- NPI Number
- 1649602632
- Entity Type
- Organization
- Organization Name
- Demp Fern Mg Dental Corp.
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Aug 1, 2013
- Last Updated
- Aug 1, 2013
Practice Location
- Address
- 6223 DEMPSTER ST
- City
- Morton Grove
- State
- Illinois
- ZIP Code
- 60053-2818
- Phone
- (847) 966-8000
Authorized Official
- Name
- DR. JAMES P KANELLOS, DDS
- Title
- OWNER/DENTIST
- Phone
- (312) 391-7529
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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