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General NPI Number Information
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NPI Number | 1790384394
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Entity Type | Organization
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Legal Business Name | BATTLE BRACES, LTD.
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Dates
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Enumeration Date | 10/23/2020
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Last Update Date | 10/23/2020
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Provider Practice Location Address
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Address Line | 3506 S STATE ST
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City | CHICAGO
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State | IL
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Zip | 60609-1910
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Country | US
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Telephone | 312-429-5533
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Fax |
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Provider Business Mailing Address
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Address Line | 3506 S STATE ST
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City | CHICAGO
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State | IL
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Zip | 60609-1910
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Country | US
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Telephone | 312-429-5533
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Fax |
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Authorized Official
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Title or Position | OWNER/ORTHODONTIST
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Name | DR. YVETTE BATTLE
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Credential | DDS, MS
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Telephone | 312-429-5533
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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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 | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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