Provider Demographics
NPI:1841462769
Name:WILLIAM R. BJORK, D.D.S.,LTD.
Entity type:Organization
Organization Name:WILLIAM R. BJORK, D.D.S.,LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:BJORK
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-925-8606
Mailing Address - Street 1:5452 S KEDZIE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60632-2620
Mailing Address - Country:US
Mailing Address - Phone:773-925-8606
Mailing Address - Fax:773-925-6031
Practice Address - Street 1:5452 S KEDZIE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60632-2620
Practice Address - Country:US
Practice Address - Phone:773-925-8606
Practice Address - Fax:773-925-6031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-01
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019017167122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty