Provider Demographics
NPI:1689065799
Name:A BRUSH WITH DENTISTRY II, P.C.
Entity Type:Organization
Organization Name:A BRUSH WITH DENTISTRY II, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAILEE
Authorized Official - Middle Name:S
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-217-4490
Mailing Address - Street 1:108 N PEORIA AVE
Mailing Address - Street 2:
Mailing Address - City:DIXON
Mailing Address - State:IL
Mailing Address - Zip Code:61021-2027
Mailing Address - Country:US
Mailing Address - Phone:815-288-1418
Mailing Address - Fax:815-288-1419
Practice Address - Street 1:108 N PEORIA AVE
Practice Address - Street 2:
Practice Address - City:DIXON
Practice Address - State:IL
Practice Address - Zip Code:61021-2027
Practice Address - Country:US
Practice Address - Phone:815-288-1418
Practice Address - Fax:815-288-1419
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-10
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-027415261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental