Provider Demographics
NPI:1548803935
Name:DR. MURILLO DDS INC
Entity Type:Organization
Organization Name:DR. MURILLO DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:BLANCA
Authorized Official - Middle Name:ESTELA
Authorized Official - Last Name:MURILLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-424-5759
Mailing Address - Street 1:5036 S ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60632-4247
Mailing Address - Country:US
Mailing Address - Phone:773-424-5759
Mailing Address - Fax:773-424-6021
Practice Address - Street 1:5036 S ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-4247
Practice Address - Country:US
Practice Address - Phone:773-424-5759
Practice Address - Fax:773-424-6021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental