My Dental Home LLC
Clinic/Center, Dental in Orland Park, IL. Organization (NPI-2).
NPI number1861273047
StatusActive
Last updated in NPPESOct 12, 2023
Details
- NPI
- 1861273047
- Entity type
- Organization (NPI-2)
- Legal business name
- My Dental Home LLC
- Organization subpart
- No
- Enumeration date
- Oct 12, 2023
- Certification date
- Oct 12, 2023
- Last updated
- Oct 12, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- My Dental Home (Doing Business As)
Practice location
1700 Ravinia PlOrland Park, IL 60462-3543
Phone 708-696-1004 · Fax 708-696-1045
Mailing address
1700 Ravinia PlOrland Park, IL 60462-3543
Phone 708-696-1004 · Fax 708-696-1045
Authorized official
Bilal Alnahass
Owner/Manager
3312017077
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