Individual
CLARISSA MERTENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3009 E 92ND ST, CHICAGO, IL 60617-4502
(708) 491-7445
Mailing address
15591 FRANCES LN, ORLAND PARK, IL 60462-7707
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019030813
IL
Other
Enumeration date
07/05/2016
Last updated
07/05/2016
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