Suburban Dental Center | |
7942 W Oakton St Niles IL 60714-2457 | |
(847) 823-0260 | |
(847) 823-0269 |
Full Name | Suburban Dental Center |
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Speciality | Dentist - General Practice |
Location | 7942 W Oakton St, Niles, Illinois |
Authorized Official Name and Position | Richard Mazanek (OWNER) |
Authorized Official Contact | 8478230260 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Suburban Dental Center 7942 W Oakton St Niles IL 60714-2457 Ph: (847) 823-0260 | Suburban Dental Center 7942 W Oakton St Niles IL 60714-2457 Ph: (847) 823-0260 |
NPI Number | 1407028624 |
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Provider Enumeration Date | 03/27/2008 |
Last Update Date | 01/12/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1407028624 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1223G0001X | Dentist - General Practice | 019018548 (Illinois) | Primary |
1223G0001X | Dentist - General Practice | 019018545 (Illinois) | Secondary |
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Nwdg Niles Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 7886 N Milwaukee Ave, Niles, IL 60714 Phone: 847-423-2488 Fax: 847-423-2492 | |
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