Organization
DENTAL IMAGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRI CRUZ (OFFICE MANAGER)
(773) 583-4455
Entity
Organization
Contact information
Practice address
4724 N KEDZIE AVE, CHICAGO, IL 60625-4421
(773) 583-4455
(773) 583-8986
Mailing address
4724 N KEDZIE AVE, CHICAGO, IL 60625-4421
(773) 583-4455
(773) 583-8986
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
04/19/2008
Last updated
04/19/2008
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