| Shaddai Dental Care | |
|
4725 W Fullerton Ave Chicago IL 60639-1817 | |
| (773) 987-2345 | |
| Not Available |
| Full Name | Shaddai Dental Care |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 4725 W Fullerton Ave, Chicago, Illinois |
| Authorized Official Name and Position | Thu Nguyen (PRESIDENT) |
| Authorized Official Contact | 7738376176 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaddai Dental Care 5324 N Elston Ave Chicago IL 60630-1611 Ph: (773) 837-6176 | Shaddai Dental Care 4725 W Fullerton Ave Chicago IL 60639-1817 Ph: (773) 987-2345 |
| NPI Number | 1093487662 |
|---|---|
| Provider Enumeration Date | 10/01/2021 |
| Last Update Date | 10/01/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093487662 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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