| Brosnan Dental Ltd | |
|
10522 S Cicero Ave Suite 204 Oak Lawn IL 60453-5200 | |
| (708) 952-9185 | |
| (708) 952-9186 |
| Full Name | Brosnan Dental Ltd |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 10522 S Cicero Ave, Oak Lawn, Illinois |
| Authorized Official Name and Position | James Glen Brosnan (PRESIDENT) |
| Authorized Official Contact | 7089529185 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brosnan Dental Ltd 10522 S Cicero Ave Suite 204 Oak Lawn IL 60453-5200 Ph: (708) 952-9185 | Brosnan Dental Ltd 10522 S Cicero Ave Suite 204 Oak Lawn IL 60453-5200 Ph: (708) 952-9185 |
| NPI Number | 1962581736 |
|---|---|
| Provider Enumeration Date | 11/03/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962581736 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 19A12667 (Illinois) | Primary |
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