Organization
CHILDREN'S DENTAL WORLD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAM PARK DDS (OWNER)
(312) 326-5437
Entity
Organization
Contact information
Practice address
2959 S WALLACE ST, CHICAGO, IL 60616
(312) 326-5437
(312) 842-5338
Mailing address
2959 S WALLACE ST, CHICAGO, IL 60616
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019025818
IL
Other
Enumeration date
12/31/2009
Last updated
12/31/2009
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