Organization
NEAR NORTH HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DESTENII THOMAS ANDERSON RDH (DENTAL HYGIENIST)
(773) 629-5488
Entity
Organization
Contact information
Practice address
4259 S BERKELEY AVE, CHICAGO, IL 60653-3030
(773) 629-5488
Mailing address
4259 S BERKELEY AVE, CHICAGO, IL 60653-3030
(773) 629-5488
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
—
—
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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