Organization
34TH STREET DENTAL CARE
Active
Other names
34th street dental care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY A BRUCCI DMD (OWNER)
(708) 484-6576
Entity
Organization
Contact information
Practice address
6411 34TH ST, BERWYN, IL 60402-3717
(708) 484-6576
(708) 484-0843
Mailing address
6411 34TH ST, BERWYN, IL 60402-3717
(708) 484-6576
(708) 484-0843
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019023728
IL
Other
Enumeration date
01/07/2010
Last updated
01/07/2010
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