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General NPI Number Information
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NPI Number | 1972462810
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Entity Type | Organization
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Legal Business Name | ANTHONY R. BENNARDO DDS PC DBA INTEGRATIVE DENTAL HEALTH
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 01/16/2026
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Provider Practice Location Address
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Address Line | 87 S MCLEAN BLVD
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City | SOUTH ELGIN
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State | IL
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Zip | 60177-1835
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Country | US
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Telephone | 847-888-8311
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Fax | 847-429-9334
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Provider Business Mailing Address
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Address Line | 87 S MCLEAN BLVD STE B
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City | SOUTH ELGIN
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State | IL
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Zip | 60177-1837
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Country | US
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Telephone | 847-888-8311
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Fax | 847-429-9334
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Authorized Official
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Title or Position | DENTIST
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Name | DR. ANTHONY R BENNARDO JR.
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Credential | DDS
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Telephone | 847-888-8311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BC3200X
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Taxonomy Name | Customized Equipment (DME)
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License Number |
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License Number State |
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