Michael L. Connolly DDS, Ltd.
Dentist in Chicago, IL. Organization (NPI-2).
NPI number1669929816
StatusActive
Last updated in NPPESSep 6, 2016
Details
- NPI
- 1669929816
- Entity type
- Organization (NPI-2)
- Legal business name
- Michael L. Connolly DDS, Ltd.
- Organization subpart
- No
- Enumeration date
- Sep 6, 2016
- Last updated
- Sep 6, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 019020342 | IL | Yes |
Practice location
6019 N Cicero AveChicago, IL 60646-4301
Phone 773-286-9700
Mailing address
6019 N Cicero AveChicago, IL 60646-4301
Phone 773-286-9700
Authorized official
Michael L Connolly
Owner/President
7732869700
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