Organization
ASSOCIATED DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES L OWENS DMD (DENTIST)
(773) 874-0404
Entity
Organization
Contact information
Practice address
747 E 79TH STREET, CHICAGO, IL 60619
(773) 874-0404
(773) 874-5900
Mailing address
PO BOX 19329, 747 E 79TH STREET, CHICAGO, IL 60619
(773) 874-0404
(773) 874-5900
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019020907
IL
Other
Enumeration date
12/19/2006
Last updated
10/29/2013
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