Organization
BERWYN DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTORIANO AVILA (DDS)
(708) 317-5150
Entity
Organization
Contact information
Practice address
6218 CERMAK RD, BERWYN, IL 60402-2322
(708) 317-5150
Mailing address
6218 CERMAK RD, BERWYN, IL 60402-2322
(708) 317-5150
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027342
IL
Other
Enumeration date
04/15/2011
Last updated
04/15/2011
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