Green Bay Trail Dentistry in Evanston - Dentist
Green Bay Trail Dentistry - NPI 1457405987
Green Bay Trail Dentistry is a Dentist in Evanston, Illinois. Green Bay Trail Dentistry practices all healthcare services and medical treatments related to Dentist. The NPI Number for Green Bay Trail Dentistry is 1457405987. The last update date is 2011-05-24.
Green Bay Trail Dentistry's current location address is 2632 Green Bay Rd, Evanston, Illinois. You can contact this provider via phone number 8478694844. The mailing address for Green Bay Trail Dentistry is 2632 Green Bay Rd, Evanston, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Green Bay Trail Dentistry |
|---|---|
| Address | 2632 Green Bay Rd, Evanston, Illinois |
| Phone Number | 8478694844 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER PROV |
|---|---|
| Authorized Official Name | Estes Eric |
| Credentials | DDS |
| Telephone Number | 8478694844 |
NPI Number Detail
| NPI Number | 1457405987 |
|---|---|
| Provider Enumeration Date | 2007-01-22 |
| Last Updated Date | 2011-05-24 |
Provider Mailing Address Detail
| Address | 2632 Green Bay Rd |
|---|---|
| City | Evanston |
| State | Illinois (IL) |
| Post Code | 60201 |
| Phone Number | 8478694844 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 19021406 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique identifier code issued to Green Bay Trail Dentistry by the Centers for Medicare & Medicaid Services?
The Green Bay Trail Dentistry has been assigned the NPI (National Provider Identifier) 1457405987. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Green Bay Trail Dentistry is physically located?
The Green Bay Trail Dentistry is physically situated at the following address: 2632 Green Bay Rd, Evanston, IL, 60201.
What is Green Bay Trail Dentistry's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Green Bay Trail Dentistry is Dentist, and the taxonomy code that classifies this field of practice is 122300000X.
When did Green Bay Trail Dentistry receive its 1457405987 assignment?
The Green Bay Trail Dentistry was assigned its 1457405987 on 2007-01-22, which is the date when this unique identifier was issued to the organization.
When was the information regarding Green Bay Trail Dentistry, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Green Bay Trail Dentistry, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2011-05-24.
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