Individual
MISS VANESSA CAMPOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1752 N TAFT AVE, BERKELEY, IL 60163-1555
(708) 449-8683
Mailing address
1752 N TAFT AVE, BERKELEY, IL 60163-1555
(708) 449-8683
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
020014796
IL
124Q00000X
Dental Hygienist
13007774A
IN
Other
Enumeration date
10/14/2016
Last updated
11/01/2016
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