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1659012920
PORTAGE PARK DENTAL STUDIO
CHICAGO, IL
NPI
1659012920
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Entity Type
Organization
Authorized Contact
DARREN DWAYNE SIMPSON
Owner
708-369-4076
Organization Subpart ?
No
Primary Taxonomy
261QD0000X Clinic/Center, Dental
Enumeration Date
2022-04-02
Last Update Date
2022-04-02
Business Address
PORTAGE PARK DENTAL STUDIO
5955 W IRVING PARK RD
CHICAGO, IL 60634-2618
Phone number: 773-481-9455
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Mailing Address
PORTAGE PARK DENTAL STUDIO
1224 LAURA LN
WOODRIDGE, IL 60517-5062
Phone number: 708-369-4076
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