Individual
YIRAN XU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4160 IL-83, STE 308, LONG GROVE, IL 60047
(847) 634-6166
Mailing address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019.034076
IL
Other
Enumeration date
05/09/2021
Last updated
08/15/2023
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