| Orland Advanced Dentistry | |
|
11315 W 143rd St Orland Park IL 60467-7221 | |
| (708) 364-0900 | |
| (708) 364-0909 |
| Full Name | Orland Advanced Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 11315 W 143rd St, Orland Park, Illinois |
| Authorized Official Name and Position | Sawsan Asfour (DOCTOR/OWNER) |
| Authorized Official Contact | 7083640900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Orland Advanced Dentistry 11315 W 143rd St Orland Park IL 60467-7221 Ph: (708) 364-0900 | Orland Advanced Dentistry 11315 W 143rd St Orland Park IL 60467-7221 Ph: (708) 364-0900 |
| NPI Number | 1295988202 |
|---|---|
| Provider Enumeration Date | 11/04/2008 |
| Last Update Date | 11/04/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295988202 | NPI | - | NPPES |
| 019026013/920038 | Medicaid | IL | |
| 019024297/1001093 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019024297 (Illinois) | Primary |
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