| Videka Dental Pc | |
|
1924 Hickory Rd Homewood IL 60430-2239 | |
| (708) 798-0444 | |
| (708) 798-3358 |
| Full Name | Videka Dental Pc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1924 Hickory Rd, Homewood, Illinois |
| Authorized Official Name and Position | Nicholas Anthony Videka (CEO) |
| Authorized Official Contact | 7087980444 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Videka Dental Pc 1924 Hickory Rd Homewood IL 60430-2239 Ph: (708) 798-0444 | Videka Dental Pc 1924 Hickory Rd Homewood IL 60430-2239 Ph: (708) 798-0444 |
| NPI Number | 1205158524 |
|---|---|
| Provider Enumeration Date | 03/01/2010 |
| Last Update Date | 03/01/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205158524 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019018734 (Illinois) | Primary |
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