Organization
KEDZIE DENTAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KHAIRUNNISA SHAIKH (OWNER)
(773) 274-9514
Entity
Organization
Contact information
Practice address
6035 N KEDZIE AVE, CHICAGO, IL 60659-2406
(773) 274-9514
Mailing address
6035 N KEDZIE AVE, CHICAGO, IL 60659-2406
(773) 274-9514
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
01/12/2016
Last updated
01/12/2016
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