Toothtown Pllc | |
303 W Lake St Ste 300 Addison IL 60101-2564 | |
(630) 352-1547 | |
Not Available |
Full Name | Toothtown Pllc |
---|---|
Speciality | Clinic/center - Dental |
Location | 303 W Lake St Ste 300, Addison, Illinois |
Authorized Official Name and Position | Yusuf Fahmy (OWNER) |
Authorized Official Contact | 6303521547 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Toothtown Pllc 1042 N Yale Ave Villa Park IL 60181-1146 Ph: (630) 352-1547 | Toothtown Pllc 303 W Lake St Ste 300 Addison IL 60101-2564 Ph: (630) 352-1547 |
NPI Number | 1508590415 |
---|---|
Provider Enumeration Date | 07/15/2022 |
Last Update Date | 07/15/2022 |
Identifier | Type | State | Issuer |
---|---|---|---|
1508590415 | NPI | - | NPPES |
019030794 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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