Individual
ALFREDO CARRASQUILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RDH
Contact information
Practice address
4104 W NELSON ST, CHICAGO, IL 60641-5441
(773) 540-1740
Mailing address
4104 W NELSON ST, CHICAGO, IL 60641-5441
(773) 540-1740
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020.014003
IL
Other
Enumeration date
07/21/2012
Last updated
07/21/2012
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