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1215198122
THUPTARA THUPVONG
CHICAGO, IL
NPI
1215198122
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019.025751)
Enumeration Date
2008-06-23
Last Update Date
2017-02-03
Business Address
Dr. THUPTARA THUPVONG D.M.D.
2632 WESTERN AVE
CHICAGO, IL 60622-2850
Phone number: 773-235-0981
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Mailing Address
Dr. THUPTARA THUPVONG D.M.D.
176 EAST DELAWARE
CHICAGO, IL 60611-7718
Phone number:
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