Optimum Dental Center, Pc

NPI 1205087285 - Dentist - 122300000X

NPI Details
NPI 1205087285
Enumeration Date 10/08/2008
Last Updated 10/08/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name DEBORAH ANN DEBORAH
Position OWNER/DENTIST
Phone (773) 239-7258
Fax (773) 239-7259
Practice Location
11076 S. LONGWOOD DR.
CHICAGO IL, 60643, US
Phone (773) 239-7258
Fax (773) 239-7259
Business Location
11076 S. LONGWOOD DR.
CHICAGO IL, 60643, US
Phone (773) 239-7258
Fax (773) 239-7259
Toxanomy
Taxonomy Code 122300000X
License State Illinois
License Number 019-022902
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According to our database, Optimum Dental Center, Pc NPI is 1205087285, taxonomy code is 122300000X and license number is 019-022902, license state is located at Illinois. Optimum Dental Center, Pc physically located at 11076 S. Longwood Dr., Chicago IL, 60643. NPI Number 1033115704 has the healthcare provider type.

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1205087285 NPI number is provided on an as is basis without warranty of any kind. 1205087285 is maintained by the National Plan & Provider Enumeration System. The contents of Optimum Dental Center, Pc are for informational purposes only.