Organization
BRITE DENTAL MARQUETTE PULASKI, P.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FADI M AQEL (PRESIDENT)
(708) 439-4655
Entity
Organization
Contact information
Practice address
6636 S PULASKI RD, CHICAGO, IL 60629-5138
(773) 884-0108
(773) 884-0159
Mailing address
6636 S PULASKI RD, CHICAGO, IL 60629-5138
(773) 776-5277
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019026128
IL
Other
Enumeration date
11/05/2012
Last updated
11/05/2012
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