| Crossroads Dental Care Llc | |
|
9532 179th St Tinley Park IL 60477-9602 | |
| (708) 444-2273 | |
| (708) 444-7380 |
| Full Name | Crossroads Dental Care Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 9532 179th St, Tinley Park, Illinois |
| Authorized Official Name and Position | Jennifer P Koch (OWNER) |
| Authorized Official Contact | 7084442273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crossroads Dental Care Llc 9532 179th St Tinley Park IL 60477-9602 Ph: (708) 444-2273 | Crossroads Dental Care Llc 9532 179th St Tinley Park IL 60477-9602 Ph: (708) 444-2273 |
| NPI Number | 1225257397 |
|---|---|
| Provider Enumeration Date | 04/25/2007 |
| Last Update Date | 07/18/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225257397 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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