Organization
DENTAL DREAMS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH LEE (ENROLLMENT COORDINATOR)
(312) 274-4526
Entity
Organization
Contact information
Practice address
5200 S WESTNEDGE AVE, PORTAGE, MI 49002-0405
(269) 382-6656
Mailing address
350 N CLARK ST STE 600, CHICAGO, IL 60654-4782
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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