| Srb Dental Pc | |
|
850 S Wabash Ave Suite 250 Chicago IL 60605-3641 | |
| (312) 663-1890 | |
| (312) 663-1895 |
| Full Name | Srb Dental Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 850 S Wabash Ave, Chicago, Illinois |
| Authorized Official Name and Position | Sheila Renee' Brown (PRESIDENT DOCTOR) |
| Authorized Official Contact | 3126631890 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Srb Dental Pc Po Box 6776 Chicago IL 60680-6776 Ph: (312) 663-1890 | Srb Dental Pc 850 S Wabash Ave Suite 250 Chicago IL 60605-3641 Ph: (312) 663-1890 |
| NPI Number | 1760539324 |
|---|---|
| Provider Enumeration Date | 01/05/2007 |
| Last Update Date | 06/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760539324 | NPI | - | NPPES |
| DNIL19737A | Other | FEP | |
| 994848 | Other | UNITED CONCORDIA | |
| 2QF679 | Other | MA | BCBS OF MASS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019019737 (Illinois) | Primary |
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