Provider Demographics
NPI:1093290181
Name:ROMO DENTAL II, P.C.
Entity Type:Organization
Organization Name:ROMO DENTAL II, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GENARO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMO
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-519-1022
Mailing Address - Street 1:6857 S PULASKI RD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60629-4151
Mailing Address - Country:US
Mailing Address - Phone:773-585-2255
Mailing Address - Fax:773-585-2278
Practice Address - Street 1:6857 S PULASKI RD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60629-4151
Practice Address - Country:US
Practice Address - Phone:773-585-2255
Practice Address - Fax:773-585-2278
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental