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NPI Code Detail

MEDICARE: WEBSTER DENTAL CARE OF LAKEVIEW, LTD

MEDICARE: WEBSTER DENTAL CARE OF LAKEVIEW, LTD
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
11223E0200XEndodontics021001607IL
21223G0001XGeneral Practice Dentistry019015631IL

General Provider Information

NPI Number : 1326258484
Entity Type Code : Organization
Provider Name (Legal Business Name) : WEBSTER DENTAL CARE OF LAKEVIEW, LTD
Provider Business Mailing Address
First Line : 6548 N NOKOMIS AVE
Second Line :
City : LINCOLNWOOD
State : IL
Zip : 60712-3026
Country : US
Telephone Number : 847-763-5890
Fax Number :
Provider Business Practice Location Address
First Line : 2829 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60657-6932
Country : US
Telephone Number : 773-528-8900
Fax Number : 773-528-0831
Authorized Official
Title or Position : PRESIDENT
Name : DR. STEVEN P REMPAS
Credential : D.D.S.
Telephone Number : 773-528-8900
Provider Enumeration Date : 05/23/2007
Last Update Date : 04/07/2016

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Directions to “WEBSTER DENTAL CARE OF LAKEVIEW, LTD ” Practice Location

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