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Organization
OAK MILL DENTAL GROUP CORP
Active
Organization
OAK MILL DENTAL GROUP CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TIMOTHY BASHFORD DDS (PRESIDENT)
(847) 470-0240
Entity
Organization
Contact information
Practice address
7900 N MILWAUKEE AVE, SUITE 2-24, NILES, IL 60714-3159
(847) 470-0240
(773) 417-4684
Mailing address
7900 N MILWAUKEE AVE STE 2-24, SUITE 224, NILES, IL 60714-3186
(847) 470-0240
(847) 470-2014
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
Other
Enumeration date
05/13/2013
Last updated
02/28/2014
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