Provider Demographics
NPI:1568951036
Name:BAND & WIRE ORTHODONTICS, LLC
Entity Type:Organization
Organization Name:BAND & WIRE ORTHODONTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMZI
Authorized Official - Middle Name:
Authorized Official - Last Name:DUAIBIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-320-8888
Mailing Address - Street 1:433 OGDEN AVE
Mailing Address - Street 2:
Mailing Address - City:CLARENDON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60514-2814
Mailing Address - Country:US
Mailing Address - Phone:630-320-8888
Mailing Address - Fax:
Practice Address - Street 1:433 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:CLARENDON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60514-2814
Practice Address - Country:US
Practice Address - Phone:630-320-8888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-09
Last Update Date:2018-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL021.0023591223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty