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Organization
UNIVERSITY DENTAL PROFESSIONALS
Active
Organization
UNIVERSITY DENTAL PROFESSIONALS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARY BETH RECKAMP (OFFICE MANAGER)
(773) 684-5702
Entity
Organization
Contact information
Practice address
5549 S CORNELL AVE, CHICAGO, IL 60637-1914
(773) 684-5702
Mailing address
5549 S CORNELL AVE, CHICAGO, IL 60637-1914
(773) 684-5702
(773) 684-5493
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019018517
IL
122300000X
Dentist
019024994
IL
122300000X
Dentist
019026856
IL
122300000X
Dentist
019026908
IL
1223G0001X
General Practice Dentistry
Primary
019018517
IL
Other
Enumeration date
04/12/2007
Last updated
07/22/2008
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