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Individual

DR. JAY ADAM DEHART

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S

Contact information

Practice address
4516 S DAMEN AVE, CHICAGO, IL 60609-3013
(920) 838-1649
Mailing address
430 W ERIE ST, SUITE 200, CHICAGO, IL 60654-6914

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019028711
IL

Other

Enumeration date
06/27/2011
Last updated
06/30/2011
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