Richard B. Diverde, DDS, Ltd
Dentist, General Practice in Chicago, IL. Organization (NPI-2).
NPI number1043767916
StatusActive
Last updated in NPPESSep 8, 2016
Details
- NPI
- 1043767916
- Entity type
- Organization (NPI-2)
- Legal business name
- Richard B. Diverde, DDS, Ltd
- Organization subpart
- No
- Enumeration date
- Sep 8, 2016
- Last updated
- Sep 8, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 019019078 | IL | Yes |
Practice location
30 N Michigan AveSte. 1405
Chicago, IL 60602-3402
Phone 312-263-7822
Mailing address
30 N Michigan AveSte. 1405
Chicago, IL 60602-3402
Phone 312-263-7822
Authorized official
Richard B Diverde
Owner/General Dentist
3122637822
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