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Organization
FAMILY DENTAL OF ROSCOE INC
Active
Organization
FAMILY DENTAL OF ROSCOE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OLENA OBEID (CEO)
(773) 679-2419
Entity
Organization
Contact information
Practice address
3332 N WESTERN AVE, CHICAGO, IL 60618-6213
(773) 679-2419
Mailing address
3332 N WESTERN AVE, CHICAGO, IL 60618-6213
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019.028238
IL
Other
Enumeration date
06/09/2016
Last updated
06/09/2016
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