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Organization
UIC
Active
Organization
UIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JASMA MCDONALD (PEDIATRIC DENTAL RESIDENCY)
(256) 606-5080
Entity
Organization
Contact information
Practice address
1740 W TAYLOR ST, CHICAGO, IL 60612-7232
(866) 600-2273
Mailing address
316 COUNTY ROAD 599, MOULTON, AL 35650-5700
(256) 606-5080
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/17/2016
Last updated
04/17/2016
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