| Lincolnwood Mall Dental | |
|
3333 W Touhy Ave Lincolnwood IL 60712-2721 | |
| (917) 902-9515 | |
| Not Available |
| Full Name | Lincolnwood Mall Dental |
|---|---|
| Speciality | Dentist |
| Location | 3333 W Touhy Ave, Lincolnwood, Illinois |
| Authorized Official Name and Position | Rostislav Krasnov (PRESIDENT) |
| Authorized Official Contact | 7864757600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lincolnwood Mall Dental 3333 W Touhy Ave Lincolnwood IL 60712-2721 Ph: () - | Lincolnwood Mall Dental 3333 W Touhy Ave Lincolnwood IL 60712-2721 Ph: (917) 902-9515 |
| NPI Number | 1801263090 |
|---|---|
| Provider Enumeration Date | 08/24/2015 |
| Last Update Date | 08/24/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801263090 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019.028976 (Illinois) | Primary |
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