South Park Dental Care in South Holland - Dental
South Park Dental Care - NPI 1881858835
South Park Dental Care is a Dental in South Holland, Illinois. South Park Dental Care practices all healthcare services and medical treatments related to Dental. The NPI Number for South Park Dental Care is 1881858835. The last update date is 2008-07-17.
South Park Dental Care's current location address is 438 E 162nd St, South Holland, Illinois. You can contact this provider via phone number 7083330699. The mailing address for South Park Dental Care is 438 E 162nd St, South Holland, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | South Park Dental Care |
|---|---|
| Address | 438 E 162nd St, South Holland, Illinois |
| Phone Number | 7083330699 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PRESIDENT |
|---|---|
| Authorized Official Name | Johnson O Kenneth |
| Telephone Number | 7083354387 |
NPI Number Detail
| NPI Number | 1881858835 |
|---|---|
| Provider Enumeration Date | 2008-07-17 |
| Last Updated Date | 2008-07-17 |
Provider Mailing Address Detail
| Address | 438 E 162nd St |
|---|---|
| City | South Holland |
| State | Illinois (IL) |
| Post Code | 604732258 |
| Phone Number | 7083330699 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Dental |
|---|---|
| Taxonomy | 261Qd0000X |
| Licence No | 19018099 |
|
Definition: Provides general and specialized dental care and oral surgery. |
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What is the unique identifier code issued to South Park Dental Care by the Centers for Medicare & Medicaid Services?
The South Park Dental Care has been assigned the NPI (National Provider Identifier) 1881858835. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Where is the South Park Dental Care located?
The South Park Dental Care is located at 438 E 162Nd St, South Holland, IL 604732258.
What is South Park Dental Care's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for South Park Dental Care is Dental, and the taxonomy code that categorizes this field of expertise is 261Qd0000X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1881858835 to South Park Dental Care?
The Centers for Medicare & Medicaid Services originally issued the 1881858835 to South Park Dental Care on 2008-07-17.
When was the information related to South Park Dental Care most recently updated or refreshed?
The details pertaining to the South Park Dental Care, including its address, specialty, and other relevant information, were last updated or refreshed on 2008-07-17.
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