Comfort Care Dentistry Pllc | |
3775 Grand Ave Gurnee IL 60031-2909 | |
(847) 623-6300 | |
Not Available |
Full Name | Comfort Care Dentistry Pllc |
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Speciality | Dentist |
Location | 3775 Grand Ave, Gurnee, Illinois |
Authorized Official Name and Position | Leonardo Miguel Castillo (MEMBER/MANAGER) |
Authorized Official Contact | 5626500741 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Comfort Care Dentistry Pllc 771 Cherry Creek Dr Grayslake IL 60030-3359 Ph: () - | Comfort Care Dentistry Pllc 3775 Grand Ave Gurnee IL 60031-2909 Ph: (847) 623-6300 |
NPI Number | 1669165759 |
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Provider Enumeration Date | 06/02/2023 |
Last Update Date | 06/02/2023 |
Medicare PECOS PAC ID | 2961860986 |
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Medicare Enrollment ID | O20230623002023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1669165759 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
Provider Name | Leonardo Miguel Bachoco Castillo |
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Provider Type | Practitioner - Dentist |
Provider Identifiers | NPI Number: 1396406476 PECOS PAC ID: 3870951890 Enrollment ID: I20230623002498 |
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