Individual
LAURA M SCULLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7013 W FARRAGUT AVE, CHICAGO, IL 60656-1923
(773) 517-8384
Mailing address
7013 W FARRAGUT AVE, CHICAGO, IL 60656-1923
(773) 517-8384
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020007556
IL
Other
Enumeration date
08/19/2019
Last updated
08/19/2019
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