| That's The Tooth | |
|
2447 W 79th St Chicago IL 60652-1734 | |
| (773) 776-1285 | |
| (773) 776-3171 |
| Full Name | That's The Tooth |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2447 W 79th St, Chicago, Illinois |
| Authorized Official Name and Position | Patricia James (OWNER) |
| Authorized Official Contact | 7737761285 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| That's The Tooth 2447 W 79th St Chicago IL 60652-1734 Ph: (773) 776-1285 | That's The Tooth 2447 W 79th St Chicago IL 60652-1734 Ph: (773) 776-1285 |
| NPI Number | 1649344755 |
|---|---|
| Provider Enumeration Date | 11/20/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649344755 | NPI | - | NPPES |
| 1002342 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |
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