Periodontics and Implant Dentistry LLC

NPI #1598250995 in Chicago, Illinois

Provider Information

NPI Number: 1598250995
Entity Type: Organization
Organization Name: Periodontics and Implant Dentistry LLC
Primary Specialty: Clinic/Center - Oral and Maxillofacial Surgery
Enumeration Date: Jun 27, 2018
Last Updated: Jun 27, 2018

Practice Location

Address: 8559 S PULASKI RD
City: Chicago
State: Illinois
ZIP Code: 60652-3643
Phone: (773) 582-0035

Authorized Official

Name: HECTOR CUMMINGS
Title: OWNER
Phone: (773) 582-0035

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Oral and Maxillofacial Surgery — Oral and Maxillofacial Surgery	261QS0112X	Primary

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