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Organization
JOHN R. BIANCALANA, DDS LTD.
Active
Organization
JOHN R. BIANCALANA, DDS LTD.
Active
Other names
Shawnway Plaza Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ROBERT BIANCALANA DDS (OWNER/DENTIST/PRESIDENT)
(847) 985-5552
Entity
Organization
Contact information
Practice address
640 MEACHAM RD, ELK GROVE VILLAGE, IL 60007-3003
(847) 985-5552
(847) 985-9049
Mailing address
640 MEACHAM RD, ELK GROVE VILLAGE, IL 60007-3003
(847) 985-5552
(847) 985-9049
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225246929
INDIVIDUAL NPI
IL
Enumeration date
04/17/2008
Last updated
04/17/2008
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