Healthcare Provider Details

I. General information

NPI: 1649204835
Provider Name (Legal Business Name): 888 ORTHODONTICS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2043 W IRVING PARK RD
CHICAGO IL
60618-3935
US

IV. Provider business mailing address

2043 W IRVING PARK RD
CHICAGO IL
60618-3935
US

V. Phone/Fax

Practice location:
  • Phone: 773-348-8008
  • Fax:
Mailing address:
  • Phone: 773-348-8008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. WILLIAM V. DOLGI
Title or Position: PRINCIPAL
Credential: D.D.S., M.S.
Phone: 773-348-8008