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171 W 10th St Suite 100 Chicago Heights IL 60411-2072 | |
| (708) 503-5001 | |
| (708) 503-5008 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 171 W 10th St, Chicago Heights, Illinois |
| Authorized Official Name and Position | Vincent Ralph Cres (PRESIDENT) |
| Authorized Official Contact | 7085035001 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
171 W 10th St Suite 100 Chicago Heights IL 60411-2072 Ph: (708) 503-5001 | 171 W 10th St Suite 100 Chicago Heights IL 60411-2072 Ph: (708) 503-5001 |
| NPI Number | 1407290208 |
|---|---|
| Provider Enumeration Date | 04/23/2013 |
| Last Update Date | 04/23/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407290208 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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