Organization
MILWAUKEE DENTAL CLINIC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IMAD BAHRANI DDS (OWNER/DOCTOR)
(773) 282-7906
Entity
Organization
Contact information
Practice address
4254 N MILWAUKEE AVE, CHICAGO, IL 60641-1643
(773) 282-7906
(773) 427-2740
Mailing address
4254 N MILWAUKEE AVE, CHICAGO, IL 60641-1643
(773) 282-7906
(773) 427-2740
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019017511
IL
Other
Enumeration date
11/20/2014
Last updated
11/20/2014
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