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General NPI Number Information
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NPI Number | 1508907544
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Entity Type | Organization
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Legal Business Name | KRZYSZTOF AUGUSTYN DENTAL CARE
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Dates
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Enumeration Date | 02/11/2007
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Last Update Date | 03/10/2014
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Provider Practice Location Address
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Address Line | 6033 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60634-5116
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Country | US
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Telephone | 773-237-9373
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Fax | 773-237-9398
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Provider Business Mailing Address
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Address Line | 6033 W BELMONT AVE
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City | CHICAGO
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State | IL
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Zip | 60634-5116
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Country | US
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Telephone | 773-237-9373
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Fax | 773-237-9398
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Authorized Official
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Title or Position | DDS
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Name | DR. KRZYSZTOF AUGUSTYN
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Credential |
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Telephone | 773-237-9373
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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 | 019-024850
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License Number State | IL
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