Organization
CHICAGO DENTAL SALON, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WESLEY ERIC CAMPIN DDS (PRESIDENT/OWNER)
(708) 425-2542
Entity
Organization
Contact information
Practice address
10004 S KEDZIE AVE, EVERGREEN PARK, IL 60805-3420
(708) 425-2542
Mailing address
10004 S KEDZIE AVE, EVERGREEN PARK, IL 60805-3420
(708) 425-2542
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019017931
IL
Other
Enumeration date
06/26/2012
Last updated
06/26/2012
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