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General NPI Number Information
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NPI Number | 1982875563
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Entity Type | Organization
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Legal Business Name | CHICAGO DENTAL CARE INC
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Dates
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Enumeration Date | 03/21/2008
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Last Update Date | 03/21/2008
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Provider Practice Location Address
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Address Line | 7122 N CLARK ST
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City | CHICAGO
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State | IL
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Zip | 60626-2408
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Country | US
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Telephone | 773-274-9009
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Fax | 773-274-9009
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Provider Business Mailing Address
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Address Line | 7122 N CLARK ST
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City | CHICAGO
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State | IL
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Zip | 60626-2408
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Country | US
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Telephone | 773-274-9009
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Fax | 773-274-9009
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Authorized Official
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Title or Position | PRESIDENT
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Name | HOSSEIN ARAGHI
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Credential | DMD
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Telephone | 773-274-9009
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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 | 19023088
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License Number State | IL
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