| Southwest Endodontics | |
|
16055 108th Ave Ste H Orland Park IL 60467-5347 | |
| (708) 460-9191 | |
| (708) 460-9407 |
| Full Name | Southwest Endodontics |
|---|---|
| Speciality | Dentist - Endodontics |
| Location | 16055 108th Ave, Orland Park, Illinois |
| Authorized Official Name and Position | Vladimir Tismensky (PRESIDENT) |
| Authorized Official Contact | 7085768442 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southwest Endodontics 16055 108th Ave Ste H Orland Park IL 60467-5347 Ph: (708) 460-9191 | Southwest Endodontics 16055 108th Ave Ste H Orland Park IL 60467-5347 Ph: (708) 460-9191 |
| NPI Number | 1982934972 |
|---|---|
| Provider Enumeration Date | 01/13/2010 |
| Last Update Date | 05/28/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982934972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223E0200X | Dentist - Endodontics | 02101135 (Illinois) | Primary |
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