| Scba Casaclang Dds Ltd | |
|
495 N Riverside Dr Ste 204 Gyrnee IL 60031 | |
| (847) 336-8611 | |
| (847) 336-8199 |
| Full Name | Scba Casaclang Dds Ltd |
|---|---|
| Speciality | Dentist |
| Location | 495 N Riverside Dr Ste 204, Gyrnee, Illinois |
| Authorized Official Name and Position | Cynthia Baldovino Casaclang (PRESIDENT) |
| Authorized Official Contact | 8473368611 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Scba Casaclang Dds Ltd 495 N Riverside Dr Ste 204 Gyrnee IL 60031 Ph: (847) 336-8611 | Scba Casaclang Dds Ltd 495 N Riverside Dr Ste 204 Gyrnee IL 60031 Ph: (847) 336-8611 |
| NPI Number | 1205055001 |
|---|---|
| Provider Enumeration Date | 04/24/2007 |
| Last Update Date | 01/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205055001 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019022958 (Illinois) | Primary |