# ADVANCED DENTAL CARE OF CICERO, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced Dental Care of Cicero
- **Organization subpart:** No

## Provider details

- **NPI number:** 1992563696
- **Authorized official:** DENISE BEVER (REGIONAL MANAGER)
- **Authorized official phone:** (317) 509-6499

## Contact information

- **Practice address:** 130 W JACKSON ST, CICERO, IN 46034-5005
- **Practice address phone:** (317) 509-6499
- **Mailing address:** 130 W JACKSON ST, CICERO, IN 46034-5005

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | — | Yes |

## Other

- **Enumeration date:** 03/08/2024
- **Last updated:** 03/08/2024