Organization
A MELISSA VARGAS DMD, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. A MELISSA LOPEZ DMD (PRESIDENT)
(773) 758-2010
Entity
Organization
Contact information
Practice address
2222 W DIVISION ST, SUITE 130, CHICAGO, IL 60622-2717
(773) 772-7373
Mailing address
3541 N LOWELL AVE, CHICAGO, IL 60641-3835
(773) 758-2010
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019025964
IL
Other
Enumeration date
05/12/2008
Last updated
08/16/2012
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