Organization
E L O DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OSMAR RODRIGUEZ DDS (PRESIDENT)
(773) 879-3400
Entity
Organization
Contact information
Practice address
1328 W ALGONQUIN RD, ARLINGTON HTS, IL 60005-3401
(847) 818-0700
Mailing address
1328 W ALGONQUIN RD, ARLINGTON HTS, IL 60005-3401
(847) 818-0700
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019025096
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019018384
IL
Other
Enumeration date
08/22/2013
Last updated
08/22/2013
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