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Individual

DR. SERENA MITCHUAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.D.S.

Contact information

Practice address
801 S PAULINA ST RM 256, CHICAGO, IL 60612-7210
(240) 535-1456
Mailing address
801 S PAULINA ST, CHICAGO, IL 60612-7210

Taxonomy

Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
019.030320
IL
1223P0221X
Pediatric Dentistry
Primary
9411
AZ

Other

Enumeration date
05/07/2013
Last updated
07/18/2016
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