MEDICARE: BRYAN ESLINGER ENDODONTICS, PC

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
1	1223E0200X	Endodontics	019028471	IL

General Provider Information

NPI Number	:	1992168371
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRYAN ESLINGER ENDODONTICS, PC

Provider Business Mailing Address
First Line	:	615 W EUCLID AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-5301
Country	:	US
Telephone Number	:	224-248-9101
Fax Number	:	224-347-2848

Provider Business Practice Location Address
First Line	:	615 W EUCLID AVE
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-5301
Country	:	US
Telephone Number	:	224-248-9101
Fax Number	:	224-347-2888

Authorized Official
Title or Position	:	ENDODONTIST
Name	:	MR. BRYAN ESLINGER
Credential	:	DDS, MS
Telephone Number	:	224-248-9101

Provider Enumeration Date	:	04/01/2016
Last Update Date	:	05/18/2016

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