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General NPI Number Information
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NPI Number | 1699489831
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Entity Type | Organization
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Legal Business Name | MICHAEL COSMOS D.M.D. P.C.
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Dates
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Enumeration Date | 01/12/2023
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 332 N YORK ST
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City | ELMHURST
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State | IL
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Zip | 60126-2318
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Country | US
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Telephone | 630-832-1212
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Fax |
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Provider Business Mailing Address
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Address Line | 1207 TORREY PINES CT
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City | NAPERVILLE
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State | IL
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Zip | 60540-1400
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Country | US
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Telephone | 630-701-0010
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MICHAEL BASIL COSMOS
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Credential | DMD
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Telephone | 630-701-0010
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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 |
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License Number State |
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