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Organization
PEARLY WHITES DENTAL INC
Active
Organization
PEARLY WHITES DENTAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MYROSLAW DYCHIY (PRESIDENT)
(773) 486-5264
Entity
Organization
Contact information
Practice address
810 N WOLCOTT AVE, UNIT C, CHICAGO, IL 60622-7555
(773) 486-5264
(773) 486-5264
Mailing address
810 N WOLCOTT AVE, UNIT C, CHICAGO, IL 60622-7555
(773) 486-5264
(773) 486-5264
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19026279
IL
Other
Enumeration date
03/13/2007
Last updated
08/22/2020
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