Organization
MONTROSE FAMILY DENTAL CENTER
Active
Other names
Edward G. Vivit, DDS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD G. VIVIT D.D.S. (PRESIDENT)
(773) 478-9393
Entity
Organization
Contact information
Practice address
3338 W MONTROSE AVE, CHICAGO, IL 60618-1247
(773) 478-9393
(773) 478-9303
Mailing address
3338 W MONTROSE AVE, CHICAGO, IL 60618-1247
(773) 478-9393
(773) 478-9303
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019022192
IL
Other
Enumeration date
02/07/2007
Last updated
06/03/2015
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