# LINCOLN PARK ORAL & COSMETIC SURGERY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Lincoln Park Institute
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225258957
- **Authorized official:** DR. MARVIN GREENE D.D.S. (PRESIDENT)
- **Authorized official phone:** (773) 327-2400

## Contact information

- **Practice address:** 2449 N LINCOLN AVE, CHICAGO, IL 60614-2414
- **Practice address phone:** (773) 327-2400
- **Practice address fax:** (773) 327-4759
- **Mailing address:** 2449 N LINCOLN AVE, CHICAGO, IL 60614-2414
- **Mailing address phone:** (773) 327-2400
- **Mailing address fax:** (773) 327-4759

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | IL | Yes |

## Other

- **Enumeration date:** 04/26/2007
- **Last updated:** 07/21/2022