Allcare Orthodontic Center LLC

Organization Active NPI Orthodontics and Dentofacial Orthopedics Dentistry · Chicago, IL

NPI 1457775710 · NPPES record last updated Feb 7, 2014

Key facts

NPI
1457775710
Entity type
Organization (NPI type 2)
Primary specialty
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X
License
019026824 (IL)
Legal business name
ALLCARE ORTHODONTIC CENTER LLC
Practice address
842 W 31St St
Chicago, IL 60608-5837
Phone
(312) 804-8304
NPI assigned
Feb 7, 2014
Organization subpart
No

Authorized official

Name
Dr. Budi Kusnoto, DDS, MS
Title
President
Phone
(312) 804-8304

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

47 W Polk St
Ste 251
Chicago, IL 60605

842 W 31st St
Chicago, IL 60608
Phone (312) 804-8304

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223X0400X 019026824 IL Yes

Addresses

Primary practice location

842 W 31St St
Chicago, IL 60608-5837

Mailing address

47 W Polk St Ste 251
Chicago, IL 60605-2000
Phone (312) 804-8304

Other providers in Chicago, IL

All providers in Chicago, IL · Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

Sources for this page

Verify at the official NPI Registry.