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Organization
SONRISA FAMILY DENTAL AT THE HALL, P.C.
Active
Organization
SONRISA FAMILY DENTAL AT THE HALL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK MENDIOLA D.D.S. (DENTIST/OWNER)
(248) 210-8049
Entity
Organization
Contact information
Practice address
4608 A & B WEST DIVERSEY AVENUE, CHICAGO, IL 60639
(248) 210-8049
Mailing address
4608 A & B WEST DIVERSEY AVENUE, CHICAGO, IL 60639
(248) 210-8049
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.026772
IL
Other
Enumeration date
10/14/2009
Last updated
10/14/2009
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