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Organization
NORTHWESTERN DENTURE CLINIC LLC
Active
Organization
NORTHWESTERN DENTURE CLINIC LLC
Active
Other names
crossroads of american dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. INCHUN YANG D.D.S (OWNER)
(708) 868-1771
Entity
Organization
Contact information
Practice address
1721 SIBLEY BLVD, CALUMET CITY, IL 60409-2240
(708) 868-1771
Mailing address
1721 SIBLEY BLVD, CALUMET CITY, IL 60409-2240
(708) 868-1771
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19025360
IL
Other
Enumeration date
02/10/2012
Last updated
02/10/2012
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