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NPI Code Detail

MEDICARE: DENTAL INNOVATIONS LTD

MEDICARE: DENTAL INNOVATIONS 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
1122300000XDentistIL

General Provider Information

NPI Number : 1457473159
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL INNOVATIONS LTD
Provider Business Mailing Address
First Line : 4554 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60625-2103
Country : US
Telephone Number : 773-784-4554
Fax Number : 773-784-4668
Provider Business Practice Location Address
First Line : 4554 N LINCOLN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60625-2103
Country : US
Telephone Number : 773-784-4554
Fax Number : 773-784-4668
Authorized Official
Title or Position : CEO
Name : THOMAS EDWARD MURRAY
Credential : DDS
Telephone Number : 773-784-4554
Provider Enumeration Date : 04/04/2007
Last Update Date : 08/22/2020

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Directions to “DENTAL INNOVATIONS LTD ” Practice Location

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