| Park Place Dental Llc | |
|
7702 W North Ave Elmwood Park IL 60707-4123 | |
| (708) 453-7275 | |
| Not Available |
| Full Name | Park Place Dental Llc |
|---|---|
| Speciality | Dentist |
| Location | 7702 W North Ave, Elmwood Park, Illinois |
| Authorized Official Name and Position | Zachary N Soiya (OWNER) |
| Authorized Official Contact | 6304537275 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Place Dental Llc 7702 W North Ave Elmwood Park IL 60707-4123 Ph: (708) 453-7275 | Park Place Dental Llc 7702 W North Ave Elmwood Park IL 60707-4123 Ph: (708) 453-7275 |
| NPI Number | 1316100514 |
|---|---|
| Provider Enumeration Date | 07/08/2008 |
| Last Update Date | 07/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1316100514 | NPI | - | NPPES |
| 1821135823 | Other | IL | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 1917894 (Illinois) | Primary |
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