Organization
ORTHODONTIC EXPERTS
Active
Organization
ORTHODONTIC EXPERTS
Active
Parent organization
ORTHODONTIC EXPERTS LTD
Organization subpart
Yes
Provider details
NPI number
Legal business name
ORTHODONTIC EXPERTS LTD
Authorized official
MONIKA BZDAL (MANGER)
(773) 801-7171
Entity
Organization
Contact information
Practice address
1654 W NORTH AVE, CHICAGO, IL 60622-2255
(312) 767-2088
Mailing address
1654 W NORTH AVE, CHICAGO, IL 60622-2255
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
021002488
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019028280
—
IL
Enumeration date
01/24/2018
Last updated
01/21/2020
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