Organization
CJN LOOP DENTAL LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE DAVITTO (OFFICE MANAGER)
(312) 236-8065
Entity
Organization
Contact information
Practice address
30 N MICHIGAN AVE STE 622, CHICAGO, IL 60602-3821
(312) 236-8065
Mailing address
30 N MICHIGAN AVE STE 622, CHICAGO, IL 60602-3821
(312) 236-8065
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
04/24/2019
Last updated
04/24/2019
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