| Aurora Orthodontics And Periodontics | |
|
3535 E New York St Aurora IL 60504-4465 | |
| (630) 338-1652 | |
| (630) 689-1358 |
| Full Name | Aurora Orthodontics And Periodontics |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 3535 E New York St, Aurora, Illinois |
| Authorized Official Name and Position | Jose Chacon (ORTHODONTIST) |
| Authorized Official Contact | 6303381658 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aurora Orthodontics And Periodontics 3535 E New York St Aurora IL 60504-4465 Ph: (630) 338-1652 | Aurora Orthodontics And Periodontics 3535 E New York St Aurora IL 60504-4465 Ph: (630) 338-1652 |
| NPI Number | 1982006763 |
|---|---|
| Provider Enumeration Date | 09/23/2014 |
| Last Update Date | 09/23/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982006763 | NPI | - | NPPES |
| 200384161 | Medicaid | IL | |
| 065880272 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 019026187 (Illinois) | Secondary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 019026092 (Illinois) | Primary |
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