| Destiny Dental | |
|
712 E 87th St Suite D Chicago IL 60619-6246 | |
| (708) 386-4800 | |
| Not Available |
| Full Name | Destiny Dental |
|---|---|
| Speciality | Dentist |
| Location | 712 E 87th St, Chicago, Illinois |
| Authorized Official Name and Position | Jason M Grinter (PRESIDENT) |
| Authorized Official Contact | 7733695428 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Destiny Dental 137 N Oak Park Ave Suite 200 Oak Park IL 60301-1344 Ph: () - | Destiny Dental 712 E 87th St Suite D Chicago IL 60619-6246 Ph: (708) 386-4800 |
| NPI Number | 1821301102 |
|---|---|
| Provider Enumeration Date | 07/15/2010 |
| Last Update Date | 07/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821301102 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
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