Organization
DENTAL DREAM TEAM ASSOCIATES LLC YETTA MCCULLOM SOLE MBR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YETTA G MCCULLOM DDS (MANAGER SOLE MEMBER)
(773) 488-9072
Entity
Organization
Contact information
Practice address
820 E 87TH ST STE 201, CHICAGO, IL 60619-6256
(773) 488-9072
(888) 506-5697
Mailing address
820 E 87TH ST STE 201, CHICAGO, IL 60619-6256
(773) 488-9072
(888) 506-5697
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
10/09/2019
Last updated
10/09/2019
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