Organization
BRENT E AGRAN, DDS, LLC
Active
Other names
Northside Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT E. AGRAN DDS (OWNER)
(773) 561-2237
Entity
Organization
Contact information
Practice address
5820 N. CLARK ST., 1S, CHICAGO, IL 60660
(773) 561-2237
(773) 878-5467
Mailing address
5820 N. CLARK ST., 1S, CHICAGO, IL 60660
(773) 561-2237
(773) 878-5467
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027610
IL
Other
Enumeration date
08/15/2014
Last updated
08/02/2018
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