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General NPI Number Information
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NPI Number | 1629203302
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Entity Type | Organization
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Legal Business Name | MENGYU TSAI DDS LTD
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Dates
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Enumeration Date | 05/24/2009
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Last Update Date | 05/24/2009
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Provider Practice Location Address
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Address Line | 9530 LOWELL AVE
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City | SKOKIE
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State | IL
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Zip | 60076-1465
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Country | US
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Telephone | 847-933-9463
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Fax |
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Provider Business Mailing Address
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Address Line | 9530 LOWELL AVE
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City | SKOKIE
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State | IL
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Zip | 60076-1465
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MENGYU TSAI
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Credential | DDS
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Telephone | 847-933-9463
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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 | 060.009782
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License Number State | IL
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