Individual
MAXIME BOUVAGNET
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4641 W DIVERSEY AVE, CHICAGO, IL 60639-1828
(773) 692-4147
Mailing address
1541 W WELLINGTON AVE # G, CHICAGO, IL 60657-4014
(312) 493-0956
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019034281
IL
Other
Enumeration date
05/30/2023
Last updated
05/30/2023
About Stedi
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