BRANDON ROGERS PRUSA

CHICAGO, IL
NPI1295045797
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy122300000X Dentist
(Licence: IL  019028511)
Enumeration Date2010-10-18
Last Update Date2010-10-18
Business Address
Dr. BRANDON ROGERS PRUSA DDS
4516 S DAMEN AVE
CHICAGO, IL 60609-3013
Phone number: 773-869-0200
Mailing Address
Dr. BRANDON ROGERS PRUSA DDS
2348 N LISTER AVE APT 407
CHICAGO, IL 60614-2994
Phone number: 785-979-5147