Bayberry Dental Care Pc

NPI 1376693457 - Dentist - 1223G0001X

NPI Details
NPI 1376693457
Enumeration Date 01/11/2007
Last Updated 09/26/2011
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name KATHLEEN M KATHLEEN
Position DENTIST PRESIDENT A CORPORATION
Phone (708) 802-8300
Fax (708) 802-8305
Practice Location
8014 171ST STREET
TINLEY PARK IL, 60477, US
Phone (708) 802-8300
Fax (708) 802-8305
Business Location
8014 171ST STREET
TINLEY PARK IL, 60477, US
Phone (708) 802-8300
Fax (708) 802-8305
Toxanomy
Taxonomy Code 1223G0001X
License State Illinois
License Number 019023208
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According to our database, Bayberry Dental Care Pc NPI is 1376693457, taxonomy code is 1223G0001X and license number is 019023208, license state is located at Illinois. Bayberry Dental Care Pc physically located at 8014 171st Street, Tinley Park IL, 60477. NPI Number 1033115704 has the healthcare provider type.

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1376693457 NPI number is provided on an as is basis without warranty of any kind. 1376693457 is maintained by the National Plan & Provider Enumeration System. The contents of Bayberry Dental Care Pc are for informational purposes only.