Organization
DENTAL 360-BUCKTOWN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMED PARVEZ DMD (MEMBER)
(773) 798-9382
Entity
Organization
Contact information
Practice address
2500 W NORTH AVE, CHICAGO, IL 60647-5202
(773) 360-1281
Mailing address
2500 W NORTH AVE, CHICAGO, IL 60647-5202
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/23/2021
Last updated
01/23/2021
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