| Shawnway Plaza Dental Center | |
|
640 Meacham Rd Elk Grove Village IL 60007-3003 | |
| (847) 985-5552 | |
| (847) 985-9049 |
| Full Name | Shawnway Plaza Dental Center |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 640 Meacham Rd, Elk Grove Village, Illinois |
| Authorized Official Name and Position | John Robert Biancalana (OWNER/DENTIST/PRESIDENT) |
| Authorized Official Contact | 8479855552 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shawnway Plaza Dental Center 640 Meacham Rd Elk Grove Village IL 60007-3003 Ph: (847) 985-5552 | Shawnway Plaza Dental Center 640 Meacham Rd Elk Grove Village IL 60007-3003 Ph: (847) 985-5552 |
| NPI Number | 1962676163 |
|---|---|
| Provider Enumeration Date | 04/17/2008 |
| Last Update Date | 04/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962676163 | NPI | - | NPPES |
| 1225246929 | Other | IL | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Illinois) | Primary |
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