| Chicago Dental Salon, P.c. | |
|
10004 S Kedzie Ave Evergreen Park IL 60805-3420 | |
| (708) 425-2542 | |
| Not Available |
| Full Name | Chicago Dental Salon, P.c. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 10004 S Kedzie Ave, Evergreen Park, Illinois |
| Authorized Official Name and Position | Wesley Eric Campin (PRESIDENT/OWNER) |
| Authorized Official Contact | 7084252542 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Dental Salon, P.c. 10004 S Kedzie Ave Evergreen Park IL 60805-3420 Ph: (708) 425-2542 | Chicago Dental Salon, P.c. 10004 S Kedzie Ave Evergreen Park IL 60805-3420 Ph: (708) 425-2542 |
| NPI Number | 1801150610 |
|---|---|
| Provider Enumeration Date | 06/26/2012 |
| Last Update Date | 06/26/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801150610 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019017931 (Illinois) | Primary |
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