| Family Dental Care | |
|
2841 Grand Ave Waukegan IL 60085-2372 | |
| (847) 360-1610 | |
| (847) 360-1689 |
| Full Name | Family Dental Care |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2841 Grand Ave, Waukegan, Illinois |
| Authorized Official Name and Position | Brusela F. Villa (GENERALIST/ASSISTANT BOOKKEEPER) |
| Authorized Official Contact | 7734584443 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Dental Care 2841 Grand Ave Waukegan IL 60085-2372 Ph: (847) 360-1610 | Family Dental Care 2841 Grand Ave Waukegan IL 60085-2372 Ph: (847) 360-1610 |
| NPI Number | 1053706481 |
|---|---|
| Provider Enumeration Date | 04/02/2015 |
| Last Update Date | 04/02/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053706481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019021973 (Illinois) | Primary |
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