Organization
HEALTHCARE FOR DENTAL SYSTEMS
Active
Other names
Managed Care Dental Systems
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BERNARD M. COLE D.D.S. (PRESIDENT)
(773) 267-1199
Entity
Organization
Contact information
Practice address
3550 W PETERSON AVE, SUITE 305, CHICAGO, IL 60659-3270
(773) 267-1199
(773) 267-5599
Mailing address
3550 W PETERSON AVE, SUITE 305, CHICAGO, IL 60659-3270
(773) 267-1199
(773) 267-5599
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DORAL 109141
—
IL
Enumeration date
04/01/2008
Last updated
04/01/2008
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