Organization
ARTESIAN DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HORACE C. BROY JR. DR. (DENTIST)
(773) 536-1434
Entity
Organization
Contact information
Practice address
227 E. 47TH STREET, CHICAGO, IL 60653
(773) 536-1434
(773) 536-1378
Mailing address
227 E 47TH ST, CHICAGO, IL 60653-3903
(773) 536-1434
(773) 536-1378
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019022596
IL
Other
Enumeration date
04/23/2008
Last updated
04/23/2008
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