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Individual

DR. MICHAEL ROYAL MINTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
990 W FULLERTON AVE, SUITE 450, CHICAGO, IL 60614-2458
(773) 935-1855
(773) 935-1888
Mailing address
990 W FULLERTON AVE, SUITE 450, CHICAGO, IL 60614-2458
(773) 935-1855
(773) 935-1888

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
IL

Other

Enumeration date
05/11/2007
Last updated
07/08/2007
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