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NPI Code Detail

MEDICARE: PROCARE DENTAL GROUP, P.C.

MEDICARE: PROCARE DENTAL GROUP, P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist060-008822IL

General Provider Information

NPI Number : 1558428730
Entity Type Code : Organization
Provider Name (Legal Business Name) : PROCARE DENTAL GROUP, P.C.
Provider Business Mailing Address
First Line : 605 E ALGONQUIN RD
Second Line : STE 300
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-4373
Country : US
Telephone Number : 847-640-1112
Fax Number : 847-640-1107
Provider Business Practice Location Address
First Line : 605 E ALGONQUIN RD
Second Line : STE 400
City : ARLINGTON HEIGHTS
State : IL
Zip : 60005-4373
Country : US
Telephone Number : 847-640-1122
Fax Number : 847-640-1160
Authorized Official
Title or Position : C.E.O.
Name : MS. ROBERT G. BRUNETTI
Credential : D.D.S.
Telephone Number : 847-640-1112
Provider Enumeration Date : 01/03/2007
Last Update Date : 06/18/2008

Similar Medicare Providers

1114975828 — PROCARE DENTAL GROUP, P.C.
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1083639389 — DR. VITO G GIUSTINO D.D.S
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1992718894 — DR. JOSEPH W LEHMAN D.D.S.
Practice Location Address:
605 E ALGONQUIN RD , STE 400
ARLINGTON HEIGHTS, IL
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Practice Fax: 847-640-1160

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