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Organization
VON WESTERNHAGEN DENTAL CORPORATION
Active
Organization
VON WESTERNHAGEN DENTAL CORPORATION
Active
Other names
CanAm Dental
Organization subpart
No
Provider details
NPI number
Authorized official
PETER STATHAKIS (CREDENTIALING)
(312) 274-4546
Entity
Organization
Contact information
Practice address
4160 E HIGHLAND AVE STE J, HIGHLAND, CA 92346-2750
(312) 274-4546
Mailing address
350 N CLARK ST STE 600, CHICAGO, IL 60654-4782
(312) 274-4581
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/28/2022
Last updated
11/01/2022
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