NPI 1003008459

Philip E Fidel, DDS

Practitioner General Practice Dentistry Chicago, IL

Practice location

Address: 3236 W Fullerton Ave, Chicago, IL 60647-2512
Phone: (773) 276-0300
Fax: (773) 252-5994

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 01922169 (IL)

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Registry record

NPI: 1003008459
Entity type: Individual
Sex (as registered): Male
NPI issued: 9 Aug 2007
Record last updated: 9 Aug 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.