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General NPI Number Information
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NPI Number | 1952890691
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Entity Type | Organization
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Legal Business Name | DENTIST ON THE PARK, INC.
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Dates
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Enumeration Date | 05/08/2018
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Last Update Date | 05/08/2018
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Provider Practice Location Address
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Address Line | 8 S MICHIGAN AVE STE 1306
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City | CHICAGO
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State | IL
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Zip | 60603-3377
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Country | US
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Telephone | 872-888-9010
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Fax | 872-888-9015
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Provider Business Mailing Address
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Address Line | 8 S MICHIGAN AVE STE 1306
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City | CHICAGO
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State | IL
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Zip | 60603-3377
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Country | US
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Telephone | 872-888-9010
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Fax | 872-888-9015
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | DR. ERIC M SCHOENING
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Credential | DDS
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Telephone | 872-888-9010
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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 | 019029186
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License Number State | IL
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