| Ravenswood Dental Pllc | |
|
5015 N Paulina St Ste 330 Chicago IL 60640-2756 | |
| (773) 774-3555 | |
| Not Available |
| Full Name | Ravenswood Dental Pllc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5015 N Paulina St Ste 330, Chicago, Illinois |
| Authorized Official Name and Position | Theodore Siegel (DENTIST) |
| Authorized Official Contact | 7737728400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ravenswood Dental Pllc 1440 Sheridan Rd Unit Ul102 Wilmette IL 60091-1838 Ph: (847) 648-1980 | Ravenswood Dental Pllc 5015 N Paulina St Ste 330 Chicago IL 60640-2756 Ph: (773) 774-3555 |
| NPI Number | 1154112472 |
|---|---|
| Provider Enumeration Date | 05/15/2025 |
| Last Update Date | 05/15/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154112472 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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