Park Place Dental Llc | |
7702 W North Ave Elmwood Park IL 60707-4123 | |
(708) 453-7275 | |
Not Available |
Full Name | Park Place Dental Llc |
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Speciality | Dentist |
Location | 7702 W North Ave, Elmwood Park, Illinois |
Authorized Official Name and Position | Zachary N Soiya (OWNER) |
Authorized Official Contact | 6304537275 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Park Place Dental Llc 7702 W North Ave Elmwood Park IL 60707-4123 Ph: (708) 453-7275 | Park Place Dental Llc 7702 W North Ave Elmwood Park IL 60707-4123 Ph: (708) 453-7275 |
NPI Number | 1316100514 |
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Provider Enumeration Date | 07/08/2008 |
Last Update Date | 07/08/2008 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316100514 | NPI | - | NPPES |
1821135823 | Other | IL | NPI |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
122300000X | Dentist | 1917894 (Illinois) | Primary |
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