Countryside Dental Group, Pc | |
6335 Joliet Rd 200 Countryside IL 60525-7427 | |
(708) 352-1830 | |
Not Available |
Full Name | Countryside Dental Group, Pc |
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Speciality | Dentist - General Practice |
Location | 6335 Joliet Rd, Countryside, Illinois |
Authorized Official Name and Position | Leila Shahbandar (PRESIDENT) |
Authorized Official Contact | 3124982937 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Countryside Dental Group, Pc 6335 Joliet Rd Ste 200 Countryside IL 60525-3986 Ph: (708) 352-1830 | Countryside Dental Group, Pc 6335 Joliet Rd 200 Countryside IL 60525-7427 Ph: (708) 352-1830 |
NPI Number | 1265812507 |
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Provider Enumeration Date | 06/02/2015 |
Last Update Date | 08/19/2015 |
Identifier | Type | State | Issuer |
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1265812507 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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1223G0001X | Dentist - General Practice | 019028019 (Illinois) | Primary |
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