| City Kids Dental, Pc | |
|
4700 N Western Ave Suite 1a Chicago IL 60625-2081 | |
| (773) 293-2700 | |
| (773) 293-3854 |
| Full Name | City Kids Dental, Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4700 N Western Ave, Chicago, Illinois |
| Authorized Official Name and Position | Mary Elizabeth Tierney (PRESIDENT) |
| Authorized Official Contact | 7732932700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| City Kids Dental, Pc 4700 N Western Ave Suite 1a Chicago IL 60625-2081 Ph: (773) 293-2700 | City Kids Dental, Pc 4700 N Western Ave Suite 1a Chicago IL 60625-2081 Ph: (773) 293-2700 |
| NPI Number | 1013068972 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013068972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (Illinois) | Primary |
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