| Dr. Reynolds Cosmetic Dental Center | |
|
101 Madison St Suite 301 Oak Park IL 60302-4278 | |
| (708) 383-0500 | |
| (708) 383-0800 |
| Full Name | Dr. Reynolds Cosmetic Dental Center |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 101 Madison St, Oak Park, Illinois |
| Authorized Official Name and Position | Pamela Reynolds (DENTIST/PRESIDENT) |
| Authorized Official Contact | 7083830500 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Reynolds Cosmetic Dental Center Po Box 2216 Oak Park IL 60303-2216 Ph: (708) 383-0500 | Dr. Reynolds Cosmetic Dental Center 101 Madison St Suite 301 Oak Park IL 60302-4278 Ph: (708) 383-0500 |
| NPI Number | 1992075972 |
|---|---|
| Provider Enumeration Date | 01/06/2012 |
| Last Update Date | 01/06/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992075972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019017700 (Illinois) | Primary |
| 1223G0001X | Dentist - General Practice | 019028628 (Illinois) | Secondary |
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