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General NPI Number Information
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NPI Number | 1841462769
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Entity Type | Organization
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Legal Business Name | WILLIAM R. BJORK, D.D.S.,LTD.
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Dates
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Enumeration Date | 04/01/2008
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Last Update Date | 04/01/2008
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Provider Practice Location Address
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Address Line | 5452 S KEDZIE AVE
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City | CHICAGO
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State | IL
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Zip | 60632-2620
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Country | US
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Telephone | 773-925-8606
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Fax | 773-925-6031
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Provider Business Mailing Address
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Address Line | 5452 S KEDZIE AVE
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City | CHICAGO
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State | IL
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Zip | 60632-2620
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Country | US
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Telephone | 773-925-8606
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Fax | 773-925-6031
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Authorized Official
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Title or Position | PRRESIDENT
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Name | DR. WILLIAM R. BJORK
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Credential | D.D.S.
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Telephone | 773-925-8606
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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 | 019017167
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License Number State | IL
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