Organization
MICHAEL L CONNOLLY DDS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL L CONNOLLY DDS (OWNER)
(773) 286-9700
Entity
Organization
Contact information
Practice address
6019 N CICERO AVE, CHICAGO, IL 60646-4301
(773) 286-9700
Mailing address
6019 N CICERO AVE, CHICAGO, IL 60646-4301
(773) 286-9700
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019020342
IL
Other
Enumeration date
08/29/2017
Last updated
08/29/2017
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