Individual
DR. PAUL K RENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
4310 S PULASKI RD, CHICAGO, IL 60632-4009
(773) 254-3300
Mailing address
125 E 21ST ST APT 216, CHICAGO, IL 60616-1702
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.031408
IL
Other
Enumeration date
10/09/2017
Last updated
10/09/2017
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