Modern Dental of Logan Square LLC
Modern Dental of Logan Square LLC provides General Practice Dentistry in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2016.
- Licensed in
- IL
- In the registry since
- 2016
What do these letters mean?
- LLC — Limited liability company
- A form of business registration, not a clinical qualification.
Practice location Address checks out
2645 N MilwaukeeChicago, IL 60647 Not confirmed with CMS for 10 years — call before visiting
Phone: (773) 717-5509
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X · Licence 019026403 (IL) |
|---|
Record details
| NPI number | 1639625437 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Phillip Palella — Owner · (773) 489-5700 |
| NPI enumerated | August 31, 2016 |
| Last updated in NPPES | August 31, 2016 |
| Mailing address | 2037 W Division, Chicago, IL 60622 |
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Modern Dental on Clark Street
744 N Clark St, Chicago, IL 60654-2525 · (773) 489-5700
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Modern Dental on Division
2033 W Division, Chicago, IL 60622 · (773) 489-5700
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