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Organization
WESTCHESTER FAMILY DENTAL LTD
Active
Organization
WESTCHESTER FAMILY DENTAL LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAFFAELE C AMBROSINO D.D.S. (PRESIDENT)
(708) 562-5621
Entity
Organization
Contact information
Practice address
4 WESTBROOK CORPORATE CENTER STE 102, WESTCHESTER, IL 60104
(708) 562-5621
(708) 562-7657
Mailing address
4 WESTBROOK CORPORATE CENTER STE 102, WESTCHESTER, IL 60104
(708) 562-5621
(708) 562-7657
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-025052
IL
Other
Enumeration date
11/08/2006
Last updated
07/24/2018
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