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General NPI Number Information
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NPI Number | 1346004801
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Entity Type | Organization
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Legal Business Name | DDSSCAN, LLC
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Dates
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Enumeration Date | 02/06/2024
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Last Update Date | 02/06/2024
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Provider Practice Location Address
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Address Line | 7408 KENNETH AVE
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City | SKOKIE
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State | IL
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Zip | 60076-3818
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Country | US
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Telephone | 773-592-1122
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Fax |
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Provider Business Mailing Address
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Address Line | 7408 KENNETH AVE
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City | SKOKIE
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State | IL
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Zip | 60076-3818
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Country | US
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Telephone | 877-722-6337
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ADMIR RAMIC
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Credential |
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Telephone | 773-592-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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