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General NPI Number Information
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NPI Number | 1477761567
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Entity Type | Organization
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Legal Business Name | WEST SUBURBAN DENTAL CARE, LTD.
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Dates
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Enumeration Date | 05/20/2007
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Last Update Date | 06/28/2018
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Provider Practice Location Address
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Address Line | 1901 DOUGLAS RD
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City | MONTGOMERY
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State | IL
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Zip | 60538
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Country | US
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Telephone | 630-554-0040
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Fax |
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Provider Business Mailing Address
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Address Line | 1901 DOUGLAS RD
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City | MONTGOMERY
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State | IL
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Zip | 60538-2470
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Country | US
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Telephone | 630-554-0040
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Fax | 630-554-9545
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Authorized Official
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Title or Position | OWNER
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Name | DR. LINDA GIOIA ARRICH
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Credential |
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Telephone | 630-664-9264
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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 | 019-025078
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License Number State | IL
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