Most Relevant Information
Provider Data
| NPI Number: | 1003008459 |
| Provider Name: | PHILIP E FIDEL DDS |
| Entity Type: | Individual |
| Taxonomy Code: | 1223G0001X |
| Specialty: | Dentist |
| License Number: | 01922169 |
Most Important Dates
| Enumeration Date: | 08/09/2007 |
| Last Updated: | 08/09/2007 |
Provider Practice Location
3236 W FULLERTON AVE
CHICAGO
IL
606472512
Practice Location Phone/Fax
| Phone: | 7732760300 |
| Fax: | 7732525994 |
Provider Mailing Location
3236 W FULLERTON AVE
CHICAGO
IL
606472512
Provider Mailing Phone/Fax
| Phone: | 7732760300 |
| Fax: | 7732525994 |