| Medcoa Dental Center Pc | |
|
1000 Grand Canyon Parkway #308 Hoffman Estates IL 60169-1705 | |
| (847) 843-1170 | |
| Not Available |
| Full Name | Medcoa Dental Center Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 1000 Grand Canyon Parkway #308, Hoffman Estates, Illinois |
| Authorized Official Name and Position | Eun So (OWNER) |
| Authorized Official Contact | 8478431170 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Medcoa Dental Center Pc 1000 Grand Canyon Parkway #308 Hoffman Estates IL 60169-1705 Ph: (847) 843-1170 | Medcoa Dental Center Pc 1000 Grand Canyon Parkway #308 Hoffman Estates IL 60169-1705 Ph: (847) 843-1170 |
| NPI Number | 1790171023 |
|---|---|
| Provider Enumeration Date | 04/14/2015 |
| Last Update Date | 04/14/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790171023 | NPI | - | NPPES |
| 019021947 | Medicaid | IL | |
| 1619015062 | Other | INDIVIDUAL NPI NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019021947 (Illinois) | Primary |
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