Berwyn Dental Group

NPI #1942590500 in Berwyn, Illinois

Provider Information

NPI Number: 1942590500
Entity Type: Organization
Organization Name: Berwyn Dental Group
Primary Specialty: Dentist
Enumeration Date: Apr 15, 2011
Last Updated: Apr 15, 2011

Practice Location

Address: 6218 CERMAK RD
City: Berwyn
State: Illinois
ZIP Code: 60402-2322
Phone: (708) 317-5150

Authorized Official

Name: VICTORIANO AVILA
Title: DDS
Phone: (708) 317-5150

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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