Proverbs 3 PC
Dentist, General Practice in Chicago, IL. Organization (NPI-2).
NPI number1396734026
StatusActive
Last updated in NPPESSep 6, 2013
Details
- NPI
- 1396734026
- Entity type
- Organization (NPI-2)
- Legal business name
- Proverbs 3 PC
- Organization subpart
- No
- Enumeration date
- Oct 15, 2005
- Last updated
- Sep 6, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 019022143 | IL | Yes |
Other names
- That'S The Tooth (Doing Business As)
Practice location
2447 W 79th StChicago, IL 60652-1734
Phone 773-776-1285 · Fax 773-776-3171
Mailing address
Po Box 20568Chicago, IL 60620-0568
Phone 773-776-1285 · Fax 773-776-3171
Authorized official
Patricia James
President
7737761285
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