Individual
DR. PHIMON ATSAWASUWAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1283 W. WESTGATE TERRACE, CHICAGO, IL 60607
(312) 928-9728
(815) 293-2159
Mailing address
1283 W. WESTGATE TERRACE, CHICAGO, IL 60607
(312) 928-9728
(815) 293-2159
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019028877
IL
Other
Enumeration date
04/17/2013
Last updated
06/03/2013
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