MEDICARE: SAUGANASH CENTER FOR DENTAL HEALTH 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
1	122300000X	Dentist		IL

General Provider Information

NPI Number	:	1417095530
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAUGANASH CENTER FOR DENTAL HEALTH LTD

Provider Business Mailing Address
First Line	:	4200 W PETERSON AVE
Second Line	:	SUITE 114
City	:	CHICAGO
State	:	IL
Zip	:	60646-6052
Country	:	US
Telephone Number	:	773-481-1940
Fax Number	:	773-481-4948

Provider Business Practice Location Address
First Line	:	4200 W PETERSON AVE
Second Line	:	SUITE 114
City	:	CHICAGO
State	:	IL
Zip	:	60646-6052
Country	:	US
Telephone Number	:	773-481-1940
Fax Number	:	773-481-4948

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. TUNDI M FRANK
Credential	:	DDS
Telephone Number	:	773-481-1940

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	08/22/2020

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