Organization
YAA N. OWUSU DMD, MDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAA NOEL MCDONALD DMD (PRESIDENT/PEDIATRIC DENTIST)
(773) 290-3500
Entity
Organization
Contact information
Practice address
7020 CENTENNIAL DR, TINLEY PARK, IL 60477-1649
(708) 633-8700
Mailing address
7020 CENTENNIAL DR, TINLEY PARK, IL 60477-1649
(708) 633-8700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
07/18/2023
Last updated
07/18/2023
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