| Team Dental Family Dentistry Llc | |
|
507 E 83rd St Chicago IL 60619-5002 | |
| (773) 783-8326 | |
| (773) 783-7985 |
| Full Name | Team Dental Family Dentistry Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 507 E 83rd St, Chicago, Illinois |
| Authorized Official Name and Position | Reginald T Baker (MANAGING PARTNER) |
| Authorized Official Contact | 7737838326 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Team Dental Family Dentistry Llc Po Box 15219 Chicago IL 60615-5140 Ph: (773) 783-8326 | Team Dental Family Dentistry Llc 507 E 83rd St Chicago IL 60619-5002 Ph: (773) 783-8326 |
| NPI Number | 1184989584 |
|---|---|
| Provider Enumeration Date | 07/11/2012 |
| Last Update Date | 07/11/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184989584 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019025166 (Illinois) | Primary |
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