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Contact Information

ASSOCIATED DENTAL CENTER
747 E 79TH STREET
CHICAGO, IL60619
 Phone: 773-874-0404
 Fax: 773-874-5900
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for ASSOCIATED DENTAL CENTER

NPI # 1073676946
LBN Legal business name ASSOCIATED DENTAL CENTER
Authorized official CHARLES OWENS - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 12/19/2006
Last updated 10/29/2013 - About 13 years ago
Identifiers
IL License # 019020907
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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