| Modern Dental Innovations, P C | |
|
1707 Shermer Road Suite 125 Northbrook IL 60062 | |
| (847) 498-3333 | |
| (847) 498-3339 |
| Full Name | Modern Dental Innovations, P C |
|---|---|
| Speciality | Dentist |
| Location | 1707 Shermer Road, Northbrook, Illinois |
| Authorized Official Name and Position | Tony T. Athans (OWNER) |
| Authorized Official Contact | 8474983333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Dental Innovations, P C 1707 Shermer Road Suite 125 Northbrook IL 60062-5375 Ph: (847) 498-3333 | Modern Dental Innovations, P C 1707 Shermer Road Suite 125 Northbrook IL 60062 Ph: (847) 498-3333 |
| NPI Number | 1326118340 |
|---|---|
| Provider Enumeration Date | 11/08/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326118340 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (Illinois) | Primary |
| 122300000X | Dentist | (Illinois) | Secondary |
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Edward H. Segal, D.d.s., Ltd. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1500 Shermer Rd, Suite 340w, Northbrook, IL 60062 Phone: 847-498-5630 Fax: 847-498-8801 | |
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