Organization
MARK MENDIOLA, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK MENDIOLA D.D.S. (DENTIST/OWNER)
(248) 210-8049
Entity
Organization
Contact information
Practice address
5050 S KEDZIE AVE, UNIT A, CHICAGO, IL 60632-3009
(773) 778-2200
Mailing address
345 N LASALLE ST, UNIT 4407, CHICAGO, IL 60654-6101
(248) 210-8049
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.026772
IL
Other
Enumeration date
12/17/2010
Last updated
12/17/2010
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