Provider Demographics
NPI:1891825527
Name:AMM LTD
Entity Type:Organization
Organization Name:AMM LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER (PRESIDENT)
Authorized Official - Prefix:DR
Authorized Official - First Name:PAULL
Authorized Official - Middle Name:C
Authorized Official - Last Name:GOSSETT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-354-0835
Mailing Address - Street 1:7045 VETERANS BLVD
Mailing Address - Street 2:A-1
Mailing Address - City:BURR RIDGE
Mailing Address - State:IL
Mailing Address - Zip Code:60528-5605
Mailing Address - Country:US
Mailing Address - Phone:708-354-0835
Mailing Address - Fax:630-325-5176
Practice Address - Street 1:7045 VETERANS BLVD
Practice Address - Street 2:A-1
Practice Address - City:BURR RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60528-5605
Practice Address - Country:US
Practice Address - Phone:708-354-0835
Practice Address - Fax:630-325-5176
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-06
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019018250122300000X
IL019027081122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty