| Love Dental, Inc | |
|
11139 S Halsted St Chicago IL 60628-3910 | |
| (773) 568-1600 | |
| (773) 568-1603 |
| Full Name | Love Dental, Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11139 S Halsted St, Chicago, Illinois |
| Authorized Official Name and Position | Brenda Jean Taylor (DENTIST/OWNER) |
| Authorized Official Contact | 7735681600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Love Dental, Inc 11139 S Halsted St Chicago IL 60628-3910 Ph: (773) 568-1600 | Love Dental, Inc 11139 S Halsted St Chicago IL 60628-3910 Ph: (773) 568-1600 |
| NPI Number | 1144540782 |
|---|---|
| Provider Enumeration Date | 06/06/2010 |
| Last Update Date | 10/10/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144540782 | NPI | - | NPPES |
| 1144540782 | Medicaid | IL | |
| 019023707 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019023707 (Illinois) | Primary |
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