Organization
DENTISTRY FOR CHILDREN AND FAMILIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN L BOYD (OWNER)
(312) 988-9855
Entity
Organization
Contact information
Practice address
1721 N HALSTED ST, CHICAGO, IL 60614-5501
(312) 988-9855
Mailing address
1721 N HALSTED ST, CHICAGO, IL 60614-5501
(312) 988-9855
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
019021037
IL
Other
Enumeration date
08/26/2016
Last updated
08/26/2016
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