| Maywood Family Dental Ltd | |
|
1409 S 5th Ave Maywood IL 60153-2128 | |
| (708) 865-2225 | |
| Not Available |
| Full Name | Maywood Family Dental Ltd |
|---|---|
| Speciality | Clinic/center |
| Location | 1409 S 5th Ave, Maywood, Illinois |
| Authorized Official Name and Position | James Poulos (PRESIDENT) |
| Authorized Official Contact | 7088652225 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Maywood Family Dental Ltd 1409 S 5th Ave Maywood IL 60153-2128 Ph: (708) 865-2225 | Maywood Family Dental Ltd 1409 S 5th Ave Maywood IL 60153-2128 Ph: (708) 865-2225 |
| NPI Number | 1245634534 |
|---|---|
| Provider Enumeration Date | 10/15/2014 |
| Last Update Date | 10/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245634534 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 019.016695 (Illinois) | Primary |
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