MEDICARE: TODAY'S DENTISTRY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	019020658	IL

General Provider Information

NPI Number	:	1013174960
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TODAY'S DENTISTRY

Provider Business Mailing Address
First Line	:	5667 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-4111
Country	:	US
Telephone Number	:	773-334-1801
Fax Number	:	773-334-3654

Provider Business Practice Location Address
First Line	:	5667 N CLARK ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60660-4111
Country	:	US
Telephone Number	:	773-334-1801
Fax Number	:	773-334-3654

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. MARK RIZO GAMALINDA
Credential	:	D.D.S.
Telephone Number	:	773-334-1801

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	05/19/2008

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Directions to “TODAY'S DENTISTRY ” Practice Location

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