| Agarwal Dental Clinic | |
|
1415 Emerald Ave Chicago Heights IL 60411-3517 | |
| (708) 756-7384 | |
| Not Available |
| Full Name | Agarwal Dental Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1415 Emerald Ave, Chicago Heights, Illinois |
| Authorized Official Name and Position | Donna Thompson (CEO) |
| Authorized Official Contact | 7732576770 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Agarwal Dental Clinic 1501 S California Ave Chicago IL 60608-1732 Ph: (773) 257-6770 | Agarwal Dental Clinic 1415 Emerald Ave Chicago Heights IL 60411-3517 Ph: (708) 756-7384 |
| NPI Number | 1770661019 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 08/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770661019 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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