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Organization
PULP&DENTIN
Active
Organization
PULP&DENTIN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRENE RENIERIS DDS (OWNER)
(773) 588-7840
Entity
Organization
Contact information
Practice address
1945 W. WILSON AVE., STE 5117, CHICAGO, IL 60640
(773) 588-7840
Mailing address
1945 W. WILSON AVE., STE 5117, CHICAGO, IL 60640
(773) 588-7840
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
12/27/2023
Last updated
12/27/2023
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