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Organization
THE DENTAL MASTRS OF RAVENSWOOD LLC
Active
Organization
THE DENTAL MASTRS OF RAVENSWOOD LLC
Active
Other names
Albany Park Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ERIC N. BLOOM DDS (PARTNER)
(847) 791-3850
Entity
Organization
Contact information
Practice address
1945 W. WILSON, STE # 5117, CHICAGO, IL 60640
(773) 588-7840
Mailing address
1945 W. WILSON, STE # 5117, CHICAGO, IL 60640
(773) 588-7840
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
04/03/2017
Last updated
04/03/2017
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