Organization
OLIVIA LARES DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLIVIA LARES D.D.S (PRESIDENT)
(312) 493-7988
Entity
Organization
Contact information
Practice address
2539 N KEDZIE BLVD # 2, CHICAGO, IL 60647-1670
(773) 235-3292
Mailing address
2539 N KEDZIE BLVD # 2, CHICAGO, IL 60647-1670
(773) 235-3292
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
10/03/2012
Last updated
10/03/2012
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