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NPI Code Detail

MEDICARE: BATTLE BRACES, LTD.

MEDICARE: BATTLE BRACES, 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
1122300000XDentist
21223X0400XOrthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number : 1790384394
Entity Type Code : Organization
Provider Name (Legal Business Name) : BATTLE BRACES, LTD.
Provider Business Mailing Address
First Line : 3506 S STATE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60609-1910
Country : US
Telephone Number : 312-429-5533
Fax Number :
Provider Business Practice Location Address
First Line : 3506 S STATE ST
Second Line :
City : CHICAGO
State : IL
Zip : 60609-1910
Country : US
Telephone Number : 312-429-5533
Fax Number :
Authorized Official
Title or Position : OWNER/ORTHODONTIST
Name : DR. YVETTE BATTLE
Credential : DDS, MS
Telephone Number : 312-429-5533
Provider Enumeration Date : 10/23/2020
Last Update Date : 10/23/2020

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Directions to “BATTLE BRACES, LTD. ” Practice Location

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