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Organization
DENTAL DREAM TEAM ASSOCIATES LLC YETTA MCCULLOM SOLE MBR
Active
Organization
DENTAL DREAM TEAM ASSOCIATES LLC YETTA MCCULLOM SOLE MBR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YETTA G MCCULLOM DDS (MANAGER SOLE MEMBER)
(773) 488-9072
Entity
Organization
Contact information
Practice address
820 E 87TH ST STE 201, CHICAGO, IL 60619-6256
(773) 488-9072
(888) 506-5697
Mailing address
820 E 87TH ST STE 201, CHICAGO, IL 60619-6256
(773) 488-9072
(888) 506-5697
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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