Family Dental Clinic, Pc

NPI 1780848945 - Health Maintenance Organization - 302R00000X

NPI Details
NPI 1780848945
Enumeration Date 07/16/2008
Last Updated 07/16/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name MOHAMMAD MOHAMMAD
Position DENTIST
Phone (773) 463-1904
Fax (773) 463-1257
Practice Location
3211 W LAWRENCE AVE
CHICAGO IL, 60625-5208, US
Phone (773) 463-1904
Fax (773) 463-1257
Business Location
3211 W LAWRENCE AVE
CHICAGO IL, 60625-5208, US
Phone (773) 463-1904
Fax (773) 463-1257
Toxanomy
Taxonomy Code 302R00000X
License State Illinois
License Number 01901529
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According to our database, Family Dental Clinic, Pc NPI is 1780848945, taxonomy code is 302R00000X and license number is 01901529, license state is located at Illinois. Family Dental Clinic, Pc physically located at 3211 W Lawrence Ave, Chicago IL, 60625-5208. NPI Number 1033115704 has the healthcare provider type.

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1780848945 NPI number is provided on an as is basis without warranty of any kind. 1780848945 is maintained by the National Plan & Provider Enumeration System. The contents of Family Dental Clinic, Pc are for informational purposes only.