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1003853425
EDWIN W MANGRAM
CHICAGO, IL
NPI
1003853425
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: IL 019-025445)
Enumeration Date
2006-06-02
Last Update Date
2012-11-16
Business Address
-- EDWIN W MANGRAM D.D.S.
3860 W OGDEN AVE
CHICAGO, IL 60623-2460
Phone number: 872-588-3000
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Mailing Address
-- EDWIN W MANGRAM D.D.S.
3860 W OGDEN AVE
CHICAGO, IL 60623-2460
Phone number: 872-588-3000
Copy
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