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Individual

DR. ANGELA STATHOPOULOS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
3800 N LAKE SHORE DR, 1E, CHICAGO, IL 60613-3301
(847) 778-8170
Mailing address
3800 N LAKE SHORE DR, 1E, CHICAGO, IL 60613-3301
(847) 778-8170

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.027863
IL
1223G0001X
General Practice Dentistry
55697
CA

Other

Enumeration date
10/06/2016
Last updated
10/06/2016
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