Pro Dental Il - Chad Wise PC

NPI #1861229148 in Niles, Illinois

Provider Information

NPI Number: 1861229148
Entity Type: Organization
Organization Name: Pro Dental Il - Chad Wise PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Sep 19, 2024
Last Updated: Sep 19, 2024

Practice Location

Address: 5622 W TOUHY AVE
City: Niles
State: Illinois
ZIP Code: 60714-4001
Phone: (847) 983-4202

Authorized Official

Name: SIMONE WILSON-ADELEKE, MPA-PPA
Title: DIRECTOR OF CREDENTIALING
Phone: (732) 731-8398

Specialties & Taxonomy Codes

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

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