Individual
DR. BETSY H ENRIQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
736 W 35TH ST, CHICAGO, IL 60616-4484
(773) 247-3800
Mailing address
736 W 35TH ST, CHICAGO, IL 60616-4484
(773) 247-3800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19A-14737
IL
Other
Enumeration date
04/25/2008
Last updated
04/25/2008
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