Llcdental,
NPI #1669924833 in Olympia Fields, Illinois
Provider Information
- NPI Number
- 1669924833
- Entity Type
- Organization
- Organization Name
- Llcdental,
- Primary Specialty
- Dentist
- Enumeration Date
- Nov 3, 2016
- Last Updated
- Nov 3, 2016
Practice Location
- Address
- 3494 VOLLMER RD
- City
- Olympia Fields
- State
- Illinois
- ZIP Code
- 60461-1018
- Phone
- (708) 747-2273
Authorized Official
- Name
- MR. KEVIN DALE MIMMS, M.S.
- Title
- MANAGER
- Phone
- (708) 747-2273
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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