Organization
COPELAND DENTAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAUREEN LEAKE D.D.S. (OWNER/DENTIST)
(708) 927-5111
Entity
Organization
Contact information
Practice address
5955 W IRVING PARK RD, CHICAGO, IL 60634-2618
(708) 927-5111
Mailing address
5334 W CULLOM AVE, CHICAGO, IL 60641-1304
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019027730
IL
Other
Enumeration date
08/11/2011
Last updated
08/11/2011
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