Dientes, INC.
Dentist, General Practice in Chicago, IL. Organization (NPI-2).
NPI number1023155751
StatusActive
Last updated in NPPESAug 22, 2020
Details
- NPI
- 1023155751
- Entity type
- Organization (NPI-2)
- Legal business name
- Dientes, INC.
- Organization subpart
- No
- Enumeration date
- Jan 31, 2007
- Last updated
- Aug 22, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 019026163 | IL | Yes |
Practice location
3417 W North AveChicago, IL 60647-4841
Phone 773-342-2223 · Fax 773-342-2225
Mailing address
3417 W North AveChicago, IL 60647-4841
Phone 773-342-2223 · Fax 773-342-2225
Authorized official
Jose F Camacho
Doctor Of Dental Surgery
7733422223
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