| Llcdental, | |
|
3494 Vollmer Rd Olympia Fields IL 60461-1018 | |
| (708) 747-2273 | |
| (708) 747-2238 |
| Full Name | Llcdental, |
|---|---|
| Speciality | Dentist |
| Location | 3494 Vollmer Rd, Olympia Fields, Illinois |
| Authorized Official Name and Position | Kevin Dale Mimms (MANAGER) |
| Authorized Official Contact | 7087472273 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Llcdental, 3494 Vollmer Rd Olympia Fields IL 60461-1018 Ph: (708) 747-2273 | Llcdental, 3494 Vollmer Rd Olympia Fields IL 60461-1018 Ph: (708) 747-2273 |
| NPI Number | 1669924833 |
|---|---|
| Provider Enumeration Date | 11/03/2016 |
| Last Update Date | 11/03/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669924833 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019020348 (Illinois) | Primary |
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Summerset Dental Care Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 3612 Lincoln Hwy, Suite 18, Olympia Fields, IL 60461 Phone: 708-747-1430 Fax: 708-747-9426 | |
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