| Renovatio Dental, Inc | |
|
212 E Cullerton St Apt 712 Chicago IL 60616-1293 | |
| (312) 320-3268 | |
| Not Available |
| Full Name | Renovatio Dental, Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 212 E Cullerton St Apt 712, Chicago, Illinois |
| Authorized Official Name and Position | Khanh P Nguyen (PRESIDENT) |
| Authorized Official Contact | 3123203268 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Renovatio Dental, Inc 212 E Cullerton St Apt 712 Chicago IL 60616-1293 Ph: () - | Renovatio Dental, Inc 212 E Cullerton St Apt 712 Chicago IL 60616-1293 Ph: (312) 320-3268 |
| NPI Number | 1912119553 |
|---|---|
| Provider Enumeration Date | 05/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912119553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |
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