| My Geriatric Dentist | |
|
2093 Rand Rd Des Plaines IL 60016-4727 | |
| (847) 590-1880 | |
| (708) 590-0868 |
| Full Name | My Geriatric Dentist |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2093 Rand Rd, Des Plaines, Illinois |
| Authorized Official Name and Position | Lisa Blumofe (DENTIST) |
| Authorized Official Contact | 8475901880 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| My Geriatric Dentist 2093 Rand Rd Des Plaines IL 60016-4727 Ph: (847) 590-1880 | My Geriatric Dentist 2093 Rand Rd Des Plaines IL 60016-4727 Ph: (847) 590-1880 |
| NPI Number | 1366064594 |
|---|---|
| Provider Enumeration Date | 05/11/2020 |
| Last Update Date | 05/11/2020 |
| Certification Date | 05/11/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366064594 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (NU) | Primary |
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