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General NPI Number Information
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NPI Number | 1386577641
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Entity Type | Organization
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Legal Business Name | CHICAGO WISDOM TEETH, PLLC
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Dates
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Enumeration Date | 06/05/2026
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Last Update Date | 06/05/2026
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Provider Practice Location Address
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Address Line | 722 S PRESIDENT ST STE A
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City | WHEATON
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State | IL
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Zip | 60189-6606
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Country | US
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Telephone | 312-584-1155
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Fax |
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Provider Business Mailing Address
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Address Line | 5513 W 11000 N STE 226
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City | HIGHLAND
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State | UT
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Zip | 84003-8012
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Country | US
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Telephone | 312-584-1155
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Fax | 312-283-4602
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. BENJAMIN HILTON
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Credential | DDS
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Telephone | 208-484-2376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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