Modern Dental on Clark Street
Modern Dental on Clark Street is a General Practice Dentistry in Chicago, Illinois. Registered with an NPI since 2017.
- In the registry since
- 2017
- Specialties on file
- 3
Practice location Address checks out
744 N Clark StChicago, IL 60654-2525
Phone: (773) 489-5700
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| General Practice Dentistry (primary) | Taxonomy 1223G0001X |
|---|---|
| Dental Clinic/Center | Taxonomy 261QD0000X |
| Preferred Provider Organization | Taxonomy 305R00000X |
Record details
| NPI number | 1265962674 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Phillip Palella — Owner · (773) 489-5700 |
| NPI enumerated | June 18, 2017 |
| Last updated in NPPES | June 18, 2017 |
| Mailing address | 2037 W Division St, Chicago, IL 60622-3157 |
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