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Organization
PETRIE STORER & ASSOCIATES DDS PC
Active
Organization
PETRIE STORER & ASSOCIATES DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK M STORER DDS (OWNER)
(773) 763-5353
Entity
Organization
Contact information
Practice address
7447 W TALCOTT AVE, SUITE 560, CHICAGO, IL 60631-3745
(773) 763-5353
(773) 763-3565
Mailing address
7447 W TALCOTT AVE, SUITE 560, CHICAGO, IL 60631-3745
(773) 763-5353
(773) 763-3565
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
060006717
IL
Other
Enumeration date
10/03/2006
Last updated
08/17/2015
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