| Niles Dental Care P.c. | |
|
8031 N Milwaukee Ave Niles IL 60714-2827 | |
| (847) 470-0240 | |
| Not Available |
| Full Name | Niles Dental Care P.c. |
|---|---|
| Speciality | Dentist |
| Location | 8031 N Milwaukee Ave, Niles, Illinois |
| Authorized Official Name and Position | Robert Arthur Sandusky (PRESIDENT) |
| Authorized Official Contact | 8474700240 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Niles Dental Care P.c. 8031 N Milwaukee Ave Niles IL 60714-2827 Ph: (847) 470-0240 | Niles Dental Care P.c. 8031 N Milwaukee Ave Niles IL 60714-2827 Ph: (847) 470-0240 |
| NPI Number | 1780127480 |
|---|---|
| Provider Enumeration Date | 11/29/2016 |
| Last Update Date | 11/29/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780127480 | NPI | - | NPPES |
| 1205056413 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Illinois) | Primary |
| 124Q00000X | Dental Hygienist | (Illinois) | Secondary |
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Nwdg Niles Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7886 N Milwaukee Ave, Niles, IL 60714 Phone: 847-423-2488 Fax: 847-423-2492 | |
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