Organization
GUERRA FAMILY DENTAL CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD GUERRA D.D.S (PRESIDENT)
(773) 763-6116
Entity
Organization
Contact information
Practice address
5318 W DEVON AVE, CHICAGO, IL 60646-4108
(773) 763-6116
(773) 894-0341
Mailing address
5318 W DEVON AVE, CHICAGO, IL 60646-4108
(773) 763-6116
(773) 894-0341
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019027613
IL
Other
Enumeration date
06/01/2009
Last updated
06/01/2009
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