Individual
DENNIS GAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
1525 E 53RD ST STE 734, CHICAGO, IL 60615-4575
(857) 574-0150
Mailing address
1150 W 15TH ST UNIT 236, CHICAGO, IL 60608-3688
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019032293
IL
Other
Enumeration date
07/29/2019
Last updated
12/20/2020
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