| Belmont Austin Dental Clinic Ltd | |
|
6027 W Belmont Ave Chicago IL 60634-5116 | |
| (773) 237-4291 | |
| Not Available |
| Full Name | Belmont Austin Dental Clinic Ltd |
|---|---|
| Speciality | Dentist |
| Location | 6027 W Belmont Ave, Chicago, Illinois |
| Authorized Official Name and Position | Howard M Lichtenstein (PRESIDENT) |
| Authorized Official Contact | 7732374291 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Belmont Austin Dental Clinic Ltd 6027 W Belmont Ave Chicago IL 60634-5116 Ph: (773) 237-4291 | Belmont Austin Dental Clinic Ltd 6027 W Belmont Ave Chicago IL 60634-5116 Ph: (773) 237-4291 |
| NPI Number | 1356679096 |
|---|---|
| Provider Enumeration Date | 11/18/2009 |
| Last Update Date | 11/18/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356679096 | NPI | - | NPPES |
| 1356461529 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019018134 (Illinois) | Primary |
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