| Crestwood Dental And Tmj Care Pc | |
|
13549 Cicero Ave Crestwood IL 60445-1934 | |
| (708) 388-3200 | |
| Not Available |
| Full Name | Crestwood Dental And Tmj Care Pc |
|---|---|
| Speciality | Dentist |
| Location | 13549 Cicero Ave, Crestwood, Illinois |
| Authorized Official Name and Position | Kevin Bargamian (PRESIDENT) |
| Authorized Official Contact | 7083883200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Crestwood Dental And Tmj Care Pc 13549 Cicero Ave Crestwood IL 60445-1934 Ph: () - | Crestwood Dental And Tmj Care Pc 13549 Cicero Ave Crestwood IL 60445-1934 Ph: (708) 388-3200 |
| NPI Number | 1730556101 |
|---|---|
| Provider Enumeration Date | 09/01/2015 |
| Last Update Date | 08/08/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730556101 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019024802 (Illinois) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (Illinois) | Secondary |
Michael A. Luckett D.m.d. & Associates (rivercrest), Ltd. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 4839 West Calsag Rd, #310, Crestwood, IL 60445 Phone: 708-597-9055 Fax: 216-584-1062 | |
Crestwood Dental Care Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 14301 Cicero Ave, Crestwood, IL 60445 Phone: 708-388-4301 |