Stony Island Dentalworks LLC

NPI #1922527852 in Chicago, Illinois

Provider Information

NPI Number: 1922527852
Entity Type: Organization
Organization Name: Stony Island Dentalworks LLC
Primary Specialty: Dentist
Enumeration Date: Sep 12, 2017
Last Updated: Nov 18, 2019

Practice Location

Address: 2235 E 71ST ST
City: Chicago
State: Illinois
ZIP Code: 60649-2539
Phone: (773) 493-4937

Authorized Official

Name: DR. REGINALD TORRANCE BAKER, DDS
Title: MANAGING MEMBER
Phone: (773) 493-4937

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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