| Berwyn Family Dental Center, Inc | |
|
7001 W Ogden Avenue Berwyn IL 60402-3652 | |
| (708) 749-2419 | |
| (708) 749-2429 |
| Full Name | Berwyn Family Dental Center, Inc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 7001 W Ogden Avenue, Berwyn, Illinois |
| Authorized Official Name and Position | Cristina Co (PRESIDENT) |
| Authorized Official Contact | 6303634379 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Berwyn Family Dental Center, Inc 7001 W Ogden Avenue Berwyn IL 60402-3652 Ph: (708) 749-2419 | Berwyn Family Dental Center, Inc 7001 W Ogden Avenue Berwyn IL 60402-3652 Ph: (708) 749-2419 |
| NPI Number | 1558507939 |
|---|---|
| Provider Enumeration Date | 01/06/2009 |
| Last Update Date | 01/06/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558507939 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019-022522 (Illinois) | Primary |
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