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Organization
DENTAL PROFESSIONALS OF OLD ORCHARD LTD
Active
Organization
DENTAL PROFESSIONALS OF OLD ORCHARD LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SCHWARTZ DDS (OWNER)
(847) 519-2873
Entity
Organization
Contact information
Practice address
4905 OLD ORCHARD CTR STE 728, SKOKIE, IL 60077-4734
(847) 676-1432
Mailing address
4905 OLD ORCHARD CTR STE 728, SKOKIE, IL 60077-4734
(847) 676-1432
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
08/17/2021
Last updated
10/12/2021
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