| Bloomingdale Dental Rez, Pc | |
|
1 Tiffany Pt Ste 209 Bloomingdale IL 60108-2916 | |
| (630) 671-0700 | |
| (630) 671-0546 |
| Full Name | Bloomingdale Dental Rez, Pc |
|---|---|
| Speciality | Dentist |
| Location | 1 Tiffany Pt Ste 209, Bloomingdale, Illinois |
| Authorized Official Name and Position | Alexander Reznikov (PRESIDENT) |
| Authorized Official Contact | 8478773570 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bloomingdale Dental Rez, Pc 1 Tiffany Pt Ste 209 Bloomingdale IL 60108-2916 Ph: (630) 671-0700 | Bloomingdale Dental Rez, Pc 1 Tiffany Pt Ste 209 Bloomingdale IL 60108-2916 Ph: (630) 671-0700 |
| NPI Number | 1043750714 |
|---|---|
| Provider Enumeration Date | 03/01/2017 |
| Last Update Date | 03/01/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043750714 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 019023898 (Illinois) | Secondary |
| 122300000X | Dentist | 019029473 (Illinois) | Primary |
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