Provider Demographics
NPI:1770620338
Name:ASSOCIATES FOR DENTAL CARE, LLC
Entity type:Organization
Organization Name:ASSOCIATES FOR DENTAL CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHUR
Authorized Official - Middle Name:B
Authorized Official - Last Name:JOSEPH
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:773-736-5300
Mailing Address - Street 1:4801 W PETERSON AVE
Mailing Address - Street 2:SUITE 550
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60646-5713
Mailing Address - Country:US
Mailing Address - Phone:773-736-5300
Mailing Address - Fax:773-736-0882
Practice Address - Street 1:4801 W PETERSON AVE
Practice Address - Street 2:SUITE 550
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60646-5713
Practice Address - Country:US
Practice Address - Phone:773-777-1070
Practice Address - Fax:773-738-0882
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019 016865122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty