| Park Ridge Periodontics, Inc. | |
|
511 W Talcott Rd Park Ridge IL 60068-5338 | |
| (847) 318-0066 | |
| (847) 318-9574 |
| Full Name | Park Ridge Periodontics, Inc. |
|---|---|
| Speciality | Dentist - Periodontics |
| Location | 511 W Talcott Rd, Park Ridge, Illinois |
| Authorized Official Name and Position | Charles Frank Difranco (PRESIDENT) |
| Authorized Official Contact | 8473180066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Ridge Periodontics, Inc. 511 W Talcott Rd Park Ridge IL 60068-5338 Ph: (847) 318-0066 | Park Ridge Periodontics, Inc. 511 W Talcott Rd Park Ridge IL 60068-5338 Ph: (847) 318-0066 |
| NPI Number | 1144567595 |
|---|---|
| Provider Enumeration Date | 01/04/2013 |
| Last Update Date | 01/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144567595 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0300X | Dentist - Periodontics | 021.001183 (Illinois) | Primary |
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