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General NPI Number Information
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NPI Number | 1164694261
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Entity Type | Organization
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Legal Business Name | BEATA CZECHURA D.M.D., P.C.
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 03/28/2008
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Provider Practice Location Address
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Address Line | 504 N PLUM GROVE RD STE A
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City | PALATINE
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State | IL
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Zip | 60067-8207
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Country | US
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Telephone | 847-359-3336
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Fax | 847-359-3377
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Provider Business Mailing Address
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Address Line | 504 N PLUM GROVE RD STE A
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City | PALATINE
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State | IL
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Zip | 60067-8207
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Country | US
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Telephone | 847-359-3336
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Fax | 847-359-3377
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Authorized Official
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Title or Position | DOCTOR
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Name | MS. BEATA A CZECHURA
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Credential | D.M.D., P.C.
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Telephone | 847-359-3336
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 19027144
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License Number State | IL
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