Proverbs 3 Pc

NPI 1396734026 - Dentist - 1223G0001X

NPI Details
NPI 1396734026
Enumeration Date 10/15/2005
Last Updated 09/06/2013
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name PATRICIA PATRICIA
Position PRESIDENT
Phone (773) 776-1285
Fax (773) 776-3171
Practice Location
2447 W 79TH ST
CHICAGO IL, 60652-1734, US
Phone (773) 776-1285
Fax (773) 776-3171
Business Location
PO BOX 20568
CHICAGO IL, 60620-0568, US
Phone (773) 776-1285
Fax (773) 776-3171
Toxanomy
Taxonomy Code 1223G0001X
License State Illinois
License Number 019022143
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According to our database, Proverbs 3 Pc NPI is 1396734026, taxonomy code is 1223G0001X and license number is 019022143, license state is located at Illinois. Proverbs 3 Pc physically located at 2447 W 79th St, Chicago IL, 60652-1734. NPI Number 1033115704 has the healthcare provider type.

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1396734026 NPI number is provided on an as is basis without warranty of any kind. 1396734026 is maintained by the National Plan & Provider Enumeration System. The contents of Proverbs 3 Pc are for informational purposes only.