Individual
DR. CARLA JULISSA DELAFUENTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
3057 W CERMAK RD, CHICAGO, IL 60623-3548
(773) 297-0200
Mailing address
430 W ERIE ST STE 500, CHICAGO, IL 60610-4032
(312) 274-0308
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
19027431
IL
Other
Enumeration date
06/29/2007
Last updated
07/08/2007
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