| Brite Dental 55, P.c | |
|
2759 W 55th St Chicago IL 60632-2251 | |
| (773) 776-5277 | |
| (773) 776-5278 |
| Full Name | Brite Dental 55, P.c |
|---|---|
| Speciality | Dentist |
| Location | 2759 W 55th St, Chicago, Illinois |
| Authorized Official Name and Position | Fadi M Aqel (PRESIDENT) |
| Authorized Official Contact | 7084394655 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brite Dental 55, P.c 2759 W 55th St Chicago IL 60632-2251 Ph: (773) 776-5277 | Brite Dental 55, P.c 2759 W 55th St Chicago IL 60632-2251 Ph: (773) 776-5277 |
| NPI Number | 1205180775 |
|---|---|
| Provider Enumeration Date | 11/05/2012 |
| Last Update Date | 11/05/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205180775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019026128 (Illinois) | Primary |
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