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Organization
TEAM DENTAL FAMILY DENTISTRY LLC
Active
Organization
TEAM DENTAL FAMILY DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REGINALD T BAKER D.D.S (MANAGING PARTNER)
(773) 783-8326
Entity
Organization
Contact information
Practice address
507 E 83RD ST, CHICAGO, IL 60619-5002
(773) 783-8326
(773) 783-7985
Mailing address
PO BOX 15219, CHICAGO, IL 60615-5140
(773) 783-8326
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019025166
IL
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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