Organization
MARK J. GRUNBERG, D.D.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK J GRUNBERG D.D.S. (OWNER/PRACTITIONER)
(773) 276-6600
Entity
Organization
Contact information
Practice address
3758 W CHICAGO AVE, CHICAGO, IL 60651-3823
(773) 276-6600
(773) 276-6600
Mailing address
3758 W CHICAGO AVE, CHICAGO, IL 60651-3823
(773) 276-6600
(773) 276-6600
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
IL
Other
Enumeration date
04/17/2008
Last updated
04/17/2008
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