Provider Demographics
NPI:1821776477
Name:QUANTUM DENTAL SERVICES LLC
Entity Type:Organization
Organization Name:QUANTUM DENTAL SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:
Authorized Official - Last Name:VAYMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-987-1489
Mailing Address - Street 1:1820 W WEBSTER AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-2934
Mailing Address - Country:US
Mailing Address - Phone:888-987-1489
Mailing Address - Fax:
Practice Address - Street 1:1820 W WEBSTER AVE STE 110
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-2934
Practice Address - Country:US
Practice Address - Phone:888-987-1489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Multi-Specialty