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General NPI Number Information
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NPI Number | 1053484055
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Entity Type | Organization
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Legal Business Name | COTTAGE HILL DENTAL CARE, LTD.
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 06/05/2013
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Provider Practice Location Address
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Address Line | 135 N ADDISON AVE STE B
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City | ELMHURST
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State | IL
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Zip | 60126-2819
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Country | US
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Telephone | 630-530-7998
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Fax | 630-530-2684
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Provider Business Mailing Address
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Address Line | 360 W. BUTTERFIELD RD SUITE 330
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City | ELMHURST
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State | IL
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Zip | 60126
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Country | US
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Telephone | 630-530-7998
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Fax | 630-530-2684
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Authorized Official
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Title or Position | GENERAL DENTIST
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Name | DR. RICHARD A. STEFFENS
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Credential | D.D.S.
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Telephone | 630-530-7998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019016370
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019.016370
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License Number State | IL
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