MEDICARE: DR. ARISTIDES P CONTOS DDS

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		IL

General Provider Information

NPI Number	:	1578512489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARISTIDES P CONTOS DDS

Provider Business Mailing Address
First Line	:	6428 N CALIFORNIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-5209
Country	:	US
Telephone Number	:	773-973-0531
Fax Number	:	773-262-9850

Provider Business Practice Location Address
First Line	:	6428 N CALIFORNIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60645-5209
Country	:	US
Telephone Number	:	773-973-0531
Fax Number	:	773-262-9850

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	07/08/2007

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