| Worth Palos Dentistry | |
|
7630 W 111th St Palos Hills IL 60465-2302 | |
| (708) 974-1319 | |
| (708) 974-4463 |
| Full Name | Worth Palos Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 7630 W 111th St, Palos Hills, Illinois |
| Authorized Official Name and Position | Richard Andrew Boehm (PRESIDENT) |
| Authorized Official Contact | 7089741319 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Worth Palos Dentistry 7630 W 111th St Palos Hills IL 60465-2302 Ph: (708) 974-1319 | Worth Palos Dentistry 7630 W 111th St Palos Hills IL 60465-2302 Ph: (708) 974-1319 |
| NPI Number | 1588839849 |
|---|---|
| Provider Enumeration Date | 04/28/2008 |
| Last Update Date | 04/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588839849 | NPI | - | NPPES |
| 1821160045 | Other | IL | PERSONAL NAME |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 19022901 (Illinois) | Primary |
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