Individual
DR. IRVIN BRUNO WATKINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1411 E. 53RD STREET, 2ND FLOOR, CHICAGO, IL 60615-4542
(773) 752-1234
(773) 752-4321
Mailing address
1411 E. 53RD STREET, 2ND FLOOR, CHICAGO, IL 60615-4542
(773) 752-1234
(773) 752-4321
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19A14703
IL
Other
Enumeration date
02/23/2009
Last updated
02/23/2009
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