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Organization
BRISTLE DENTAL STUDIO
Active
Organization
BRISTLE DENTAL STUDIO
Active
Parent organization
CONNIE J. WOO, DMD LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
CONNIE J. WOO, DMD LLC
Authorized official
CONNIE J WOO DMD (OWNER)
(224) 612-1383
Entity
Organization
Contact information
Practice address
1700 N WESTERN AVE UNIT A, CHICAGO, IL 60647-5324
(312) 620-7733
Mailing address
1700 N WESTERN AVE UNIT A, CHICAGO, IL 60647-5324
(312) 620-7733
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/10/2023
Last updated
01/05/2024
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