| Cicero Dental Center Llc | |
|
1639 S Cicero Ave Cicero IL 60804-1520 | |
| (708) 477-6717 | |
| (708) 477-6434 |
| Full Name | Cicero Dental Center Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1639 S Cicero Ave, Cicero, Illinois |
| Authorized Official Name and Position | Hamza Mohammed (ADMINISTRATOR) |
| Authorized Official Contact | 6304370774 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Cicero Dental Center Llc 1639 S Cicero Ave Cicero IL 60804-1520 Ph: (708) 477-6717 | Cicero Dental Center Llc 1639 S Cicero Ave Cicero IL 60804-1520 Ph: (708) 477-6717 |
| NPI Number | 1447767546 |
|---|---|
| Provider Enumeration Date | 01/10/2018 |
| Last Update Date | 05/23/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447767546 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 1710977939 (Illinois) | Primary |
| 1223G0001X | Dentist - General Practice | 1184826174 (Illinois) | Secondary |
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