Implant Endo Inc | |
505 N Lake Shore Dr Ste 215 Chicago IL 60611-3678 | |
(312) 467-3771 | |
(312) 467-4684 |
Full Name | Implant Endo Inc |
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Speciality | Clinic/center - Dental |
Location | 505 N Lake Shore Dr Ste 215, Chicago, Illinois |
Authorized Official Name and Position | Kyung-soo Choi (PRESIDENT) |
Authorized Official Contact | 2132454564 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Implant Endo Inc 505 N Lake Shore Dr Ste 215 Chicago IL 60611-3678 Ph: (213) 245-4564 | Implant Endo Inc 505 N Lake Shore Dr Ste 215 Chicago IL 60611-3678 Ph: (312) 467-3771 |
NPI Number | 1215485677 |
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Provider Enumeration Date | 09/14/2016 |
Last Update Date | 09/14/2016 |
Identifier | Type | State | Issuer |
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1215485677 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | 019024334 (Illinois) | Primary |
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