Tony Louis Minutillo in Crystal Lake - Pediatric Dentistry
Tony Louis Minutillo - NPI 1427212018
Tony Louis Minutillo is a Pediatric Dentistry in Crystal Lake, Illinois. Tony Louis Minutillo practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Tony Louis Minutillo is 1427212018. The last update date is 2008-07-14.
Tony Louis Minutillo's current location address is 820 E Terra Cotta Ave, Crystal Lake, Illinois. You can contact this provider via phone number 8153567960 and fax number 8153568051. The mailing address for Tony Louis Minutillo is 820 E Terra Cotta Ave, Crystal Lake, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Tony Louis Minutillo |
|---|---|
| Address | 820 E Terra Cotta Ave, Crystal Lake, Illinois |
| Phone Number | 8153567960 |
| Fax Number | 8153568051 |
| Sole Proprietor | Y |
| Credentials | D.D.S., M. |
NPI Number Detail
| NPI Number | 1427212018 |
|---|---|
| Provider Enumeration Date | 2008-07-14 |
| Last Updated Date | 2008-07-14 |
Provider Mailing Address Detail
| Address | 820 E Terra Cotta Ave |
|---|---|
| City | Crystal Lake |
| State | Illinois (IL) |
| Post Code | 600143649 |
| Phone Number | 8153567960 |
| Fax Number | 8153568051 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 19.022613 |
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Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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What is the unique 10-digit identifier code issued to Tony Louis Minutillo by the Centers for Medicare & Medicaid Services?
The Tony Louis Minutillo has been assigned the NPI (National Provider Identifier) 1427212018 by the CMS (Centers for Medicare & Medicaid Services). This 10-digit code serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Tony Louis Minutillo is located?
The Tony Louis Minutillo is situated at the following address: 820 E Terra Cotta Ave, Crystal Lake, IL, 600143649.
What is the area of specialization for Tony Louis Minutillo, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Tony Louis Minutillo is Pediatric Dentistry, and the corresponding taxonomy code that categorizes this area of expertise is 1223P0221X.
On what date did the Tony Louis Minutillo receive its 1427212018 assignment from the Centers for Medicare & Medicaid Services?
The Tony Louis Minutillo was assigned its 1427212018 by the Centers for Medicare & Medicaid Services on 2008-07-14.
As of what date were the details related to Tony Louis Minutillo most recently updated or revised?
The information pertaining to Tony Louis Minutillo, including its address, specialty, and other relevant details, was last updated or revised on 2008-07-14.