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Contact Information

NORTH CLARK DENTAL
6339 N CLARK ST
CHICAGO, IL60660
 Phone: 773-262-8393
 Fax: 773-262-5896
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Preferred Provider Organization

305R00000X
Indicates primary specialty

NPI Profile & details for NORTH CLARK DENTAL

NPI Number 1033465711
LBN Legal business name NORTH CLARK DENTAL
Authorized official VICTOR TOMASIAN - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 07/31/2012
Last updated 07/31/2012 - About 14 years ago
Identifiers
IL License # 019022349
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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