Provider Demographics
NPI:1205013877
Name:ASSOCIATES FOR DENTAL HEALTH, P.C.
Entity Type:Organization
Organization Name:ASSOCIATES FOR DENTAL HEALTH, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY AND TREASURER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:S
Authorized Official - Last Name:RUBINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-561-2237
Mailing Address - Street 1:5850 N CLARK ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-3202
Mailing Address - Country:US
Mailing Address - Phone:773-561-2237
Mailing Address - Fax:773-878-5467
Practice Address - Street 1:5850 N CLARK ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-3202
Practice Address - Country:US
Practice Address - Phone:773-561-2237
Practice Address - Fax:773-878-5467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-26
Last Update Date:2008-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty