Dynasty Dental | |
18 S Larkin Ave Ste 7 Joliet IL 60436-1266 | |
(815) 730-1570 | |
Not Available |
Full Name | Dynasty Dental |
---|---|
Speciality | Dentist |
Location | 18 S Larkin Ave Ste 7, Joliet, Illinois |
Authorized Official Name and Position | Ribhi Salamah (OWNER) |
Authorized Official Contact | 7735621697 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Dynasty Dental 18 S Larkin Ave Ste 7 Joliet IL 60436-1266 Ph: (815) 730-1570 | Dynasty Dental 18 S Larkin Ave Ste 7 Joliet IL 60436-1266 Ph: (815) 730-1570 |
NPI Number | 1275372187 |
---|---|
Provider Enumeration Date | 05/21/2024 |
Last Update Date | 05/21/2024 |
Identifier | Type | State | Issuer |
---|---|---|---|
1275372187 | NPI | - | NPPES |
1407548076 | Medicaid | IL | |
1609569979 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | (* (Not Available)) | Primary |
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