Individual
DR. KEVIN GARSON NG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4620 N WESTERN AVE, CHICAGO, IL 60625
(708) 552-0275
Mailing address
4620 N WESTERN AVE, CHICAGO, IL 60625
(708) 552-0275
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-029462
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/01/2012
Last updated
03/22/2019
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