BUDI KUSNOTO

CHICAGO, IL
NPI1447349618
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics
(Licence: IL  021002161)
Additional Taxonomies122300000X Dentist
(Licence: IL  019022824)
Enumeration Date2006-10-12
Last Update Date2014-01-28
Business Address
-- BUDI KUSNOTO DDS, MS
842 W 31ST ST
CHICAGO, IL 60608
Phone number: 312-804-8304
Mailing Address
-- BUDI KUSNOTO DDS, MS
47 W POLK ST SUITE 251
CHICAGO, IL 60605-2000
Phone number: 312-804-8304