Provider First Line Business Practice Location Address:
350 N CLARK ST FL 6
Provider Second Line Business Practice Location Address:
DENTAL DREAMS LLC C/O DANIELLE THARP
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60654-4712
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
312-972-3766
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2013