Organization
EAST VILLAGE DENTAL CENTRE PLLC
Active
Other names
Dental Care Alliance
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE COLE (VP INSURANCE PLAN MANAGEMENT)
(727) 424-2990
Entity
Organization
Contact information
Practice address
901 N ASHLAND AVE, CHICAGO, IL 60622-5111
(773) 341-9325
Mailing address
901 N ASHLAND AVE, CHICAGO, IL 60622-5111
(773) 341-9325
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/14/2023
Last updated
02/14/2023
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