MEDICARE: YUNEZ DENTAL & ASSOCIATES, 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	19026044	IL

General Provider Information

NPI Number	:	1679909451
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YUNEZ DENTAL & ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	3204 N PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-4728
Country	:	US
Telephone Number	:	773-202-0377
Fax Number	:

Provider Business Practice Location Address
First Line	:	3204 N PULASKI RD
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60641-4728
Country	:	US
Telephone Number	:	773-202-0377
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	SYLVIA GALINDO
Credential	:
Telephone Number	:	630-833-3330

Provider Enumeration Date	:	09/24/2013
Last Update Date	:	09/24/2013

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