Daniel T Bodine DDS PC
Organization Active NPI Dentist · Worth, IL
NPI 1164500534 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1164500534
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Dentist 122300000X
- Legal business name
- DANIEL T BODINE DDS PC
- Practice address
- 11130 South Harlem Ave
Worth, IL 60482 - Phone
- (708) 448-6760
- Fax
- (708) 448-8869
- NPI assigned
- Nov 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Daniel Thomas Bodine, DDS
- Title
- President
- Phone
- (708) 448-6760
National Provider Directory
Locations
11130 S Harlem Ave
Worth, IL 60482
Phone (708) 448-6760
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist |
122300000X | IL | Yes |
Addresses
Primary practice location
11130 South Harlem Ave
Worth, IL 60482
Mailing address
11130 South Harlem Ave
Worth, IL 60482
Phone (708) 448-6760
Other providers in Worth, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.