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NPI Code Detail

MEDICARE: KUDOS DENTAL CARE INC

MEDICARE: KUDOS DENTAL CARE INC
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
11223G0001XGeneral Practice Dentistry019030325IL

General Provider Information

NPI Number : 1225485113
Entity Type Code : Organization
Provider Name (Legal Business Name) : KUDOS DENTAL CARE INC
Provider Business Mailing Address
First Line : 7710 W NORTH AVE
Second Line :
City : ELMWOOD PARK
State : IL
Zip : 60707-4123
Country : US
Telephone Number : 708-453-6677
Fax Number :
Provider Business Practice Location Address
First Line : 7710 W NORTH AVE
Second Line :
City : ELMWOOD PARK
State : IL
Zip : 60707-4123
Country : US
Telephone Number : 708-453-6677
Fax Number :
Authorized Official
Title or Position : PRESEDENT
Name : OMAR ALDOORI
Credential : DMD
Telephone Number : 708-320-1020
Provider Enumeration Date : 05/20/2016
Last Update Date : 05/20/2016

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Directions to “KUDOS DENTAL CARE INC ” Practice Location

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