Organization
MAIN DENTAL ASSOCIATES, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD A. WILSON D.D.S. (PRESIDENT)
(847) 966-1700
Entity
Organization
Contact information
Practice address
6457 DEMPSTER ST, MORTON GROVE, IL 60053-2604
(847) 966-1700
(847) 966-1785
Mailing address
6457 DEMPSTER ST, MORTON GROVE, IL 60053-2604
(847) 966-1700
(847) 966-1785
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019-014182
IL
Other
Enumeration date
05/08/2008
Last updated
05/08/2008
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