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Organization
CHICAGOLAND COMMUNITY PEDIATRIC DENTISTRY, P.C.
Active
Organization
CHICAGOLAND COMMUNITY PEDIATRIC DENTISTRY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROSA N ORTEGA DDS (PEDIATRIC DENTIST)
(847) 579-9013
Entity
Organization
Contact information
Practice address
836 W WELLINGTON AVE, CHICAGO, IL 60657-5147
(847) 579-9013
Mailing address
5200 S MASSASOIT AVE, CHICAGO, IL 60638-1508
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019026478
IL
Other
Enumeration date
06/30/2015
Last updated
06/30/2015
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