Provider Demographics
NPI:1417403148
Name:JOYFUL DENTAL CARE
Entity Type:Organization
Organization Name:JOYFUL DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:VICTORIA
Authorized Official - Last Name:POSKOZIM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-736-7767
Mailing Address - Street 1:6314 N. CICERO AVENUE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646
Mailing Address - Country:US
Mailing Address - Phone:773-736-7767
Mailing Address - Fax:773-337-5601
Practice Address - Street 1:6314 N. CICERO AVENUE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646
Practice Address - Country:US
Practice Address - Phone:773-736-7767
Practice Address - Fax:773-337-5601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019025526261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental