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Organization
RICHARD B. DIVERDE, DDS, LTD
Active
Organization
RICHARD B. DIVERDE, DDS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD B DIVERDE D.D.S. (OWNER/GENERAL DENTIST)
(312) 263-7822
Entity
Organization
Contact information
Practice address
30 N MICHIGAN AVE, STE. 1405, CHICAGO, IL 60602-3402
(312) 263-7822
Mailing address
30 N MICHIGAN AVE, STE. 1405, CHICAGO, IL 60602-3402
(312) 263-7822
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019019078
IL
Other
Enumeration date
09/08/2016
Last updated
09/08/2016
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