PORTAGE PARK DENTAL STUDIO

CHICAGO, IL
NPI1659012920
Entity TypeOrganization
Authorized ContactDARREN DWAYNE SIMPSON
Owner
708-369-4076
Organization Subpart ?No
Primary Taxonomy261QD0000X Clinic/Center, Dental
Enumeration Date2022-04-02
Last Update Date2022-04-02
Business Address
PORTAGE PARK DENTAL STUDIO
5955 W IRVING PARK RD
CHICAGO, IL 60634-2618
Phone number: 773-481-9455
Mailing Address
PORTAGE PARK DENTAL STUDIO
1224 LAURA LN
WOODRIDGE, IL 60517-5062
Phone number: 708-369-4076
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