Evanston Dental Pllc

NPI #1841997319 in Evanston, Illinois

Provider Information

NPI Number: 1841997319
Entity Type: Organization
Organization Name: Evanston Dental Pllc
Primary Specialty: Dentist
Enumeration Date: Feb 14, 2023
Last Updated: Feb 14, 2023

Practice Location

Address: 500 DAVIS ST STE 510
City: Evanston
State: Illinois
ZIP Code: 60201-4621
Phone: (847) 864-2243

Authorized Official

Name: MIKE COLE
Title: VP INSURANCE PLAN MANAGEMENT
Phone: (727) 424-2990

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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