| Prestige Dental P C | |
|
125 E Irving Park Rd Streamwood IL 60107-2950 | |
| (630) 213-0682 | |
| (630) 213-0685 |
| Full Name | Prestige Dental P C |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 125 E Irving Park Rd, Streamwood, Illinois |
| Authorized Official Name and Position | Moeen Ikram (PRESIDENT) |
| Authorized Official Contact | 6302130666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Prestige Dental P C 125 E Irving Park Rd Streamwood IL 60107-2950 Ph: (630) 213-0682 | Prestige Dental P C 125 E Irving Park Rd Streamwood IL 60107-2950 Ph: (630) 213-0682 |
| NPI Number | 1710162581 |
|---|---|
| Provider Enumeration Date | 12/29/2007 |
| Last Update Date | 12/29/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710162581 | NPI | - | NPPES |
| 181058 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Illinois) | Primary |
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