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3354 W 26 Street Second Floor Chicago IL 60623 | |
| (773) 521-0885 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Dentist |
| Location | 3354 W 26 Street, Chicago, Illinois |
| Authorized Official Name and Position | Pablo O Torres (PRES) |
| Authorized Official Contact | 7735210885 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3354 W 26 Street Second Floor Chicago IL 60623 Ph: (773) 521-0885 | 3354 W 26 Street Second Floor Chicago IL 60623 Ph: (773) 521-0885 |
| NPI Number | 1073682811 |
|---|---|
| Provider Enumeration Date | 11/07/2006 |
| Last Update Date | 08/14/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073682811 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019022032 (Illinois) | Primary |
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