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General NPI Number Information
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NPI Number | 1558826453
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Entity Type | Organization
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Legal Business Name | BEVERLY HADLEY, DDS P.C.
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Dates
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Enumeration Date | 02/05/2019
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Last Update Date | 06/26/2020
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Provider Practice Location Address
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Address Line | 16282 PRINCE DRIVE
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473
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Country | US
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Telephone | 708-596-3800
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Fax | 708-825-9595
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Provider Business Mailing Address
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Address Line | 16282 PRINCE DRIVE
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City | SOUTH HOLLAND
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State | IL
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Zip | 60473
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Country | US
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Telephone | 708-596-3800
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Fax | 708-825-9595
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Authorized Official
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Title or Position | OWNER, PRESIDENT & SECRETARY
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Name | DR. BEVERLY HADLEY
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Credential | D.D.S.
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Telephone | 708-596-3800
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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 |
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License Number State |
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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 |
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License Number State |
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