Organization
AQUA DENTAL OF CHICAGO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAI-HONG KIM D.D.S (PRESIDENT)
(347) 534-8088
Entity
Organization
Contact information
Practice address
2346 W CERMAK RD, CHICAGO, IL 60608-3812
(773) 579-9480
(773) 579-9481
Mailing address
2346 W CERMAK RD, CHICAGO, IL 60608-3812
(773) 579-9480
(773) 579-9481
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027018
IL
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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