Provider Demographics
NPI:1265622385
Name:ADVANCED FAMILY DENTAL CARE LLC
Entity type:Organization
Organization Name:ADVANCED FAMILY DENTAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANU
Authorized Official - Middle Name:
Authorized Official - Last Name:SOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:312-451-4106
Mailing Address - Street 1:319 S BARRINGTON RD
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-5345
Mailing Address - Country:US
Mailing Address - Phone:312-451-4106
Mailing Address - Fax:
Practice Address - Street 1:319 S BARRINGTON RD
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-5345
Practice Address - Country:US
Practice Address - Phone:312-451-4106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-25
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty