Provider Demographics
NPI:1952560674
Name:DENTAL CARE CENTER LTD
Entity Type:Organization
Organization Name:DENTAL CARE CENTER LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MUZAFFAR
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRZA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-953-9999
Mailing Address - Street 1:144 W ROOSEVELT RD
Mailing Address - Street 2:
Mailing Address - City:VILLA PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60181-3504
Mailing Address - Country:US
Mailing Address - Phone:630-953-9999
Mailing Address - Fax:630-953-9998
Practice Address - Street 1:144 W ROOSEVELT RD
Practice Address - Street 2:
Practice Address - City:VILLA PARK
Practice Address - State:IL
Practice Address - Zip Code:60181-3504
Practice Address - Country:US
Practice Address - Phone:630-953-9999
Practice Address - Fax:630-953-9998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-06
Last Update Date:2014-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019019459122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty