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Organization
ALTA DENTAL LLC
Active
Organization
ALTA DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRIS WORTH DDS (OWNER)
(218) 329-2753
Entity
Organization
Contact information
Practice address
5892 S ARCHER AVE, CHICAGO, IL 60638-1658
(218) 329-2753
Mailing address
565 W QUINCY ST UNIT 1506, CHICAGO, IL 60661-2911
(218) 329-2753
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/28/2019
Last updated
08/28/2019
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