| Artistic Dental Centre | |
|
15445 South Park Ave South Holland IL 60473-1302 | |
| (708) 339-6800 | |
| (708) 339-5567 |
| Full Name | Artistic Dental Centre |
|---|---|
| Speciality | Dentist |
| Location | 15445 South Park Ave, South Holland, Illinois |
| Authorized Official Name and Position | Albert Fitz Gruber (OWNER/PRESIDENT) |
| Authorized Official Contact | 7083396800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Artistic Dental Centre 15445 S Park Ave South Holland IL 60473-1302 Ph: (708) 339-6800 | Artistic Dental Centre 15445 South Park Ave South Holland IL 60473-1302 Ph: (708) 339-6800 |
| NPI Number | 1811262223 |
|---|---|
| Provider Enumeration Date | 03/19/2012 |
| Last Update Date | 03/19/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811262223 | NPI | - | NPPES |
| 1386714210 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019-019995 (Illinois) | Primary |
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