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Organization

M & R DENTAL, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. COLEEN-SHANNON LICAR (MANAGER)
(847) 864-8151
Entity
Organization

Contact information

Practice address
1560 SHERMAN AVE STE 902, EVANSTON, IL 60201-4809
(847) 864-8151
Mailing address
1560 SHERMAN AVE STE 902, EVANSTON, IL 60201-4809
(847) 864-8151

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
08/25/2022
Last updated
08/25/2022
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