National Provider Identifier Database

NORTH CLARK DENTAL
Preferred Provider Organization

A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.


Contact Information

NORTH CLARK DENTAL
6339 N CLARK ST
CHICAGO, IL60660
Phone: 773-262-8393
Fax: 773-262-5896
Website:
Specialty Taxonomy Code
* Preferred Provider Organization 305R00000X

* Indicates primary specialty

NPI Profile & details for NORTH CLARK DENTAL

NPI Number 1033465711
Legal business name
LBN
NORTH CLARK DENTAL
Authorized official VICTOR TOMASIAN - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 07/31/2012
Last updated 07/31/2012 - About 14 years ago
Sole proprietor1 Not specified
Identifiers
  • IL License #: 019022349

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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