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NPI Code Detail

MEDICARE: DENTAL CARE ASSOCIATES

MEDICARE: DENTAL CARE ASSOCIATES
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
11223G0001XGeneral Practice Dentistry

General Provider Information

NPI Number : 1760793129
Entity Type Code : Organization
Provider Name (Legal Business Name) : DENTAL CARE ASSOCIATES
Provider Business Mailing Address
First Line : 4332 N ELSTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2144
Country : US
Telephone Number : 773-754-3500
Fax Number : 630-339-5803
Provider Business Practice Location Address
First Line : 4332 N ELSTON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2144
Country : US
Telephone Number : 773-754-3500
Fax Number : 630-339-5803
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. MIRZA BAIG
Credential :
Telephone Number : 773-754-3500
Provider Enumeration Date : 06/30/2010
Last Update Date : 06/30/2010

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Directions to “DENTAL CARE ASSOCIATES ” Practice Location

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