MEDICARE: BELMONT DENTAL CARE, P.C.

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	1223G0001X	General Practice Dentistry	060006068019021733	IL

General Provider Information

NPI Number	:	1467661462
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BELMONT DENTAL CARE, P.C.

Provider Business Mailing Address
First Line	:	3344 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1108
Country	:	US
Telephone Number	:	773-549-7971
Fax Number	:	773-348-7544

Provider Business Practice Location Address
First Line	:	3344 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1108
Country	:	US
Telephone Number	:	773-549-7971
Fax Number	:	773-348-7544

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. GILBERT PARROTT
Credential	:	D.D.S.
Telephone Number	:	773-549-7971

Provider Enumeration Date	:	05/22/2007
Last Update Date	:	08/22/2020

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