| Distinctive Dentistry | |
|
106 S Ridgeland Ave #408 Oak Park IL 60302-4613 | |
| (312) 545-8671 | |
| Not Available |
| Full Name | Distinctive Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 106 S Ridgeland Ave, Oak Park, Illinois |
| Authorized Official Name and Position | Conrad Magno (PRESIDENT) |
| Authorized Official Contact | 3125458671 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Distinctive Dentistry 106 S Ridgeland Ave #408 Oak Park IL 60302-4613 Ph: (312) 545-8671 | Distinctive Dentistry 106 S Ridgeland Ave #408 Oak Park IL 60302-4613 Ph: (312) 545-8671 |
| NPI Number | 1851529382 |
|---|---|
| Provider Enumeration Date | 06/23/2009 |
| Last Update Date | 06/23/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851529382 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019.026625 (Illinois) | Primary |
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