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Organization
VI Q QUAN DMD PC
Active
Organization
VI Q QUAN DMD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VI QUAN QUAN D.M.D. (PRESIDENT)
(773) 405-4220
Entity
Organization
Contact information
Practice address
3939 W FULLERTON AVE, CHICAGO, IL 60647-2243
(773) 235-0000
Mailing address
7723 W CLARENCE AVE, CHICAGO, IL 60631-1833
(773) 405-4220
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-026196
IL
Other
Enumeration date
02/17/2010
Last updated
02/17/2010
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