Organization
COMPASS DENTAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRANDON PRUSA D.D.S. (PRESIDENT)
(785) 979-5147
Entity
Organization
Contact information
Practice address
4413 N CLARK ST, CHICAGO, IL 60640-5403
(785) 979-5147
Mailing address
2348 N LISTER AVE, #407, CHICAGO, IL 60614-2994
(785) 979-5147
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/20/2012
Last updated
08/20/2012
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