Organization
CHOI PERIODONTICS INC
Active
Other names
Lake Point Tower Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. YOUNG CHOI D.M.D., M.S. (OWNER)
(312) 467-3201
Entity
Organization
Contact information
Practice address
505 N LAKE SHORE DR, #215, CHICAGO, IL 60611-3427
(312) 467-3201
Mailing address
505 N LAKE SHORE DR, #215, CHICAGO, IL 60611-3427
(312) 961-3179
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019025040
IL
1223P0300X
Periodontics
Primary
021002061
IL
Other
Enumeration date
02/22/2012
Last updated
02/22/2012
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