The Tooth Repair Shoppe, Ltd. in Wheaton - General Practice
The Tooth Repair Shoppe, Ltd. - NPI 1669529145
The Tooth Repair Shoppe, Ltd. is a General Practice in Wheaton, Illinois. The Tooth Repair Shoppe, Ltd. practices all healthcare services and medical treatments related to General Practice. The NPI Number for The Tooth Repair Shoppe, Ltd. is 1669529145. The last update date is 2008-06-20.
The Tooth Repair Shoppe, Ltd.'s current location address is 610 W. Roosevelt Road, Wheaton, Illinois. You can contact this provider via phone number 6306820844 and fax number 6306821428. The mailing address for The Tooth Repair Shoppe, Ltd. is 610 W. Roosevelt Road, Wheaton, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | The Tooth Repair Shoppe, Ltd. |
|---|---|
| Address | 610 W. Roosevelt Road, Wheaton, Illinois |
| Phone Number | 6306820844 |
| Fax Number | 6306821428 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | DENTIST |
|---|---|
| Authorized Official Name | Calleia C. Gregory |
| Credentials | DDS |
| Telephone Number | 6306820844 |
NPI Number Detail
| NPI Number | 1669529145 |
|---|---|
| Provider Enumeration Date | 2007-01-05 |
| Last Updated Date | 2008-06-20 |
Provider Mailing Address Detail
| Address | 610 W. Roosevelt Road |
|---|---|
| City | Wheaton |
| State | Illinois (IL) |
| Post Code | 60187 |
| Phone Number | 6306820844 |
| Fax Number | 6306821428 |
Provider's Primary Taxonomy Detail
| Speciality | General Practice |
|---|---|
| Taxonomy | 1223G0001X |
| Licence No | 60008257 |
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Definition: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
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What is the unique identification code assigned to The Tooth Repair Shoppe, Ltd. by the Centers for Medicare & Medicaid Services?
The The Tooth Repair Shoppe, Ltd. has been issued the NPI (National Provider Identifier) 1669529145. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Where is the The Tooth Repair Shoppe, Ltd. located?
The The Tooth Repair Shoppe, Ltd. is located at 610 W. Roosevelt Road, Wheaton, IL 60187.
What is The Tooth Repair Shoppe, Ltd.'s specialized field of practice, and what is the corresponding taxonomy classification code?
The The Tooth Repair Shoppe, Ltd.'s area of specialization is General Practice, and the corresponding taxonomy code that categorizes this field of practice is 1223G0001X.
On what date did the The Tooth Repair Shoppe, Ltd. receive the assignment of its 1669529145 from the Centers for Medicare & Medicaid Services?
The The Tooth Repair Shoppe, Ltd. was issued its 1669529145 by the Centers for Medicare & Medicaid Services on 2007-01-05.
When was the information pertaining to The Tooth Repair Shoppe, Ltd. most recently updated or revised?
The details related to The Tooth Repair Shoppe, Ltd., including its address, specialty, and other relevant information, were last updated or revised on 2008-06-20.