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General NPI Number Information
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NPI Number | 1447504667
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Entity Type | Organization
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Legal Business Name | CHILDREN'S ORAL CARE ONLY, P.C.
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Dates
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Enumeration Date | 11/09/2012
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Last Update Date | 11/09/2012
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Provider Practice Location Address
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Address Line | 185 MILWAUKEE AVE SUITE140
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-3010
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Country | US
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Telephone | 847-478-8100
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Fax | 847-478-8812
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Provider Business Mailing Address
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Address Line | 185 MILWAUKEE AVE SUITE140
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City | LINCOLNSHIRE
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State | IL
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Zip | 60069-3010
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Country | US
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Telephone | 847-478-8100
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Fax | 847-478-8812
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Authorized Official
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Title or Position | PEDIATRIC DENTIST
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Name | DR. CAROLINE SCHOLTZ
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Credential | D.D.S., M.S.
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Telephone | 847-478-8100
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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 | 019019265
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 0021001323
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License Number State | IL
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