Organization
HARLEM IRVING FAMILY DENTAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTY WOLTER (INSURANCE MANAGER)
(630) 869-5857
Entity
Organization
Contact information
Practice address
7601 W IRVING PARK RD STE 102, CHICAGO, IL 60634-2140
(773) 589-9220
Mailing address
1699 E WOODFIELD RD, SCHAUMBURG, IL 60173-4947
(630) 689-5857
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
19017598
IL
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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