Individual
MARIA EJSBRENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5505 N MENARD AVE, CHICAGO, IL 60630-1221
(773) 631-7070
(773) 631-3770
Mailing address
5505 N MENARD AVE, CHICAGO, IL 60630-1221
(773) 631-7070
(773) 631-3770
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
01921593
IL
Other
Enumeration date
02/27/2008
Last updated
02/27/2008
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