Organization
NGM DENTAL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NOELLE G MCCULLOM DDS (SOLE MEMBER)
(773) 892-4595
Entity
Organization
Contact information
Practice address
820 E 87TH ST STE 201, CHICAGO, IL 60619-6256
(773) 488-3738
Mailing address
820 E 87TH ST STE 201, CHICAGO, IL 60619-6256
(773) 488-3738
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
08/05/2024
Last updated
08/05/2024
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