Provider Demographics
NPI:1376044305
Name:CONFIDENTAL GROUP LLC
Entity Type:Organization
Organization Name:CONFIDENTAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MUSTAFA
Authorized Official - Middle Name:
Authorized Official - Last Name:OBAIDI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:708-453-6677
Mailing Address - Street 1:7710 W NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707-4123
Mailing Address - Country:US
Mailing Address - Phone:708-453-6677
Mailing Address - Fax:
Practice Address - Street 1:7710 W NORTH AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-4123
Practice Address - Country:US
Practice Address - Phone:708-453-6677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-25
Last Update Date:2018-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental