Organization
MICHAEL R MINTZ D.D.S.,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL ROYAL MINTZ D.D.S. (PRESIDENT)
(773) 935-1855
Entity
Organization
Contact information
Practice address
990 W FULLERTON AVE, SUITE 450, CHICAGO, IL 60614-2458
(773) 935-1855
(773) 935-1888
Mailing address
990 W FULLERTON AVE, SUITE 450, CHICAGO, IL 60614-2458
(773) 935-1855
(773) 935-1888
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
05/11/2007
Last updated
08/22/2020
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