| Dental Professionals Of Old Orchard Ltd | |
|
4905 Old Orchard Ctr Ste 728 Skokie IL 60077-4734 | |
| (847) 676-1432 | |
| Not Available |
| Full Name | Dental Professionals Of Old Orchard Ltd |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies |
| Location | 4905 Old Orchard Ctr Ste 728, Skokie, Illinois |
| Authorized Official Name and Position | David Schwartz (OWNER) |
| Authorized Official Contact | 8475192873 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dental Professionals Of Old Orchard Ltd 4905 Old Orchard Ctr Ste 728 Skokie IL 60077-4734 Ph: (847) 676-1432 | Dental Professionals Of Old Orchard Ltd 4905 Old Orchard Ctr Ste 728 Skokie IL 60077-4734 Ph: (847) 676-1432 |
| NPI Number | 1710653225 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 10/12/2021 |
| Medicare PECOS PAC ID | 3274931738 |
|---|---|
| Medicare Enrollment ID | O20211013002768 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710653225 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Primary |
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