Organization
MONTROSE DENTAL CLINIC PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FANG DDS (DENTIST)
(773) 969-0198
Entity
Organization
Contact information
Practice address
3541 W. MONTROSE AVE, UNIT 1W, CHICAGO, IL 60618
(773) 463-8000
(773) 463-8001
Mailing address
3541 W. MONTROSE AVE, UNIT 1W, CHICAGO, IL 60618
(773) 463-8000
(773) 463-8001
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019025991
IL
Other
Enumeration date
07/02/2009
Last updated
07/02/2009
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