Organization
MICHAEL L. CONNOLLY DDS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL L CONNOLLY DDS (OWNER/PRESIDENT)
(773) 286-9700
Entity
Organization
Contact information
Practice address
6019 N CICERO AVE, CHICAGO, IL 60646-4301
(773) 286-9700
Mailing address
6019 N CICERO AVE, CHICAGO, IL 60646-4301
(773) 286-9700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019020342
IL
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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