Individual
DR. ANGELIQUE FORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
533 E 33RD PL, 607, CHICAGO, IL 60616-4112
(773) 544-5302
Mailing address
533 E 33RD PL, 607, CHICAGO, IL 60616-4112
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
021002281
IL
1223G0001X
General Practice Dentistry
019026718
IL
Other
Enumeration date
09/16/2008
Last updated
09/16/2008
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