Provider Demographics
NPI:1124582002
Name:A. TOPACIO DENTAL INC
Entity Type:Organization
Organization Name:A. TOPACIO DENTAL INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:
Authorized Official - Last Name:TOPACIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-498-6233
Mailing Address - Street 1:6508 W ARCHER AVE STE 5
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-2424
Mailing Address - Country:US
Mailing Address - Phone:773-498-6233
Mailing Address - Fax:
Practice Address - Street 1:6508 W ARCHER AVE STE 5
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2424
Practice Address - Country:US
Practice Address - Phone:773-498-6233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:A. TOPACIO DENTAL INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies