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General NPI Number Information
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NPI Number | 1932452554
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Entity Type | Organization
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Legal Business Name | NIVALDO MONTES DDS SC
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Dates
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Enumeration Date | 10/19/2012
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Last Update Date | 10/30/2023
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Provider Practice Location Address
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Address Line | 25 E WASHINGTON ST STE 1721
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City | CHICAGO
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State | IL
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Zip | 60602-1899
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Country | US
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Telephone | 312-236-3226
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Fax | 312-236-9629
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Provider Business Mailing Address
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Address Line | 25 E WASHINGTON ST STE 1721
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City | CHICAGO
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State | IL
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Zip | 60602-1899
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Country | US
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Telephone | 312-236-3226
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Fax | 312-236-9629
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Authorized Official
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Title or Position | OWNER
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Name | NIVALDO MONTES
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Credential |
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Telephone | 312-236-3226
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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 | 019.022915
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License Number State | IL
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