Organization
M. ATTALLA DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MAMDOUH M. ATTALLA DDS (OWNER)
(773) 288-0225
Entity
Organization
Contact information
Practice address
2117 E 71ST ST, CHICAGO, IL 60649-2103
(773) 288-0225
(773) 288-0485
Mailing address
PO BOX 497010, CHICAGO, IL 60649-0094
(773) 288-0225
(773) 288-0485
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
01902261
IL
Other
Enumeration date
09/24/2014
Last updated
09/24/2014
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