Provider First Line Business Practice Location Address:
UNIVERSITY OF ILLINOIS AT CHICAGO COLLEGE OF DENTISTRY
Provider Second Line Business Practice Location Address:
801 S PAULINA MC 850
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60612
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-996-7531
Provider Business Practice Location Address Fax Number:
970-867-7607
Provider Enumeration Date:
02/06/2006