| Premier Dental Care Illinois Inc | |
|
1819 Church St Evanston IL 60201-3415 | |
| (847) 866-7430 | |
| Not Available |
| Full Name | Premier Dental Care Illinois Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1819 Church St, Evanston, Illinois |
| Authorized Official Name and Position | Hidayathulla Khan (OWNER) |
| Authorized Official Contact | 2244434988 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Dental Care Illinois Inc 1819 Church St Evanston IL 60201-3415 Ph: (847) 866-7430 | Premier Dental Care Illinois Inc 1819 Church St Evanston IL 60201-3415 Ph: (847) 866-7430 |
| NPI Number | 1255985669 |
|---|---|
| Provider Enumeration Date | 07/25/2019 |
| Last Update Date | 07/25/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255985669 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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