Dental Associates of Alsip, LLC

Organization Active NPI General Practice Dentistry · Alsip, IL

NPI 1669909370 · NPPES record last updated May 12, 2017

Key facts

NPI
1669909370
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Dentistry 1223G0001X
Legal business name
DENTAL ASSOCIATES OF ALSIP, LLC
Practice address
5061 West 111TH St.
Alsip, IL 60803-6074
Phone
(708) 422-6655
Fax
(708) 422-0628
NPI assigned
May 12, 2017
Organization subpart
No

Authorized official

Name
Katherine Grueneberg
Title
Chief Administrative Officer
Phone
(414) 778-5274

Practitioners 3

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

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry
Group: 193400000X SINGLE SPECIALTY GROUP
1223G0001X IL Yes

Addresses

Primary practice location

5061 West 111TH St.
Alsip, IL 60803-6074

Mailing address

3333 N Mayfair Rd
Suite 311
Wauwatosa, WI 53222-3219
Phone (414) 808-3031

Other providers in Alsip, IL

All providers in Alsip, IL · General Practice Dentistry in Illinois

Sources for this page

Verify at the official NPI Registry.