Chicago Mall Dental Associates, LLC
NPI #1700397031 in Lincolnwood, Illinois
Provider Information
- NPI Number
- 1700397031
- Entity Type
- Organization
- Organization Name
- Chicago Mall Dental Associates, LLC
- Primary Specialty
- Dentist
- Enumeration Date
- Oct 13, 2017
- Last Updated
- Oct 13, 2017
Practice Location
- Address
- 3333 W TOUHY AVE UNIT G01
- City
- Lincolnwood
- State
- Illinois
- ZIP Code
- 60712-2753
- Phone
- (847) 807-7601
Authorized Official
- Name
- ROSTISLAV KRASNOV
- Title
- OWNER
- Phone
- (786) 475-7600
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist |
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