Individual
CAMILA PERALTA-SUGANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
6735 STANLEY AVE, BERWYN, IL 60402-3129
(708) 484-0212
Mailing address
3752 N TROY ST APT 1, CHICAGO, IL 60618-4506
(773) 710-7270
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019031784
IL
Other
Enumeration date
07/20/2018
Last updated
05/17/2021
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