Provider Demographics
NPI:1649698606
Name:AAP DENTAL GROUP
Entity type:Organization
Organization Name:AAP DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:MUSUR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-763-3600
Mailing Address - Street 1:5037 N HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60656-3501
Mailing Address - Country:US
Mailing Address - Phone:773-763-3600
Mailing Address - Fax:
Practice Address - Street 1:5037 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60656-3501
Practice Address - Country:US
Practice Address - Phone:773-763-3600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-06
Last Update Date:2014-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019021332122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty