Organization
DR JACKS DENTAL LOUNGE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JACK GEISSLER DMD (CEO)
(815) 922-3635
Entity
Organization
Contact information
Practice address
1363 N ASHLAND AVE STE 1, CHICAGO, IL 60622-5192
(773) 343-3143
Mailing address
1363 N ASHLAND AVE STE 1, CHICAGO, IL 60622-5192
(773) 343-3143
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
07/24/2024
Last updated
07/24/2024
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