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General NPI Number Information
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NPI Number | 1316800378
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Entity Type | Organization
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Legal Business Name | CHICAGO DENTAL ANESTHESIA PLLC
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Dates
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Enumeration Date | 12/06/2025
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 2509 NEUBAUER CIR
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City | LINDENHURST
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State | IL
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Zip | 60046-8783
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Country | US
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Telephone | 330-903-1152
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Fax |
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Provider Business Mailing Address
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Address Line | 2509 NEUBAUER CIR
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City | LINDENHURST
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State | IL
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Zip | 60046-8783
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAMES KUNZLER
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Credential | DDS
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Telephone | 330-903-1152
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223D0004X
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Taxonomy Name | Dental Anesthesiology
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License Number |
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License Number State |
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