Organization
CICERO DENTAL CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HAMZA MOHAMMED (ADMINISTRATOR)
(630) 437-0774
Entity
Organization
Contact information
Practice address
1639 S CICERO AVE, CICERO, IL 60804-1520
(708) 477-6717
(708) 477-6434
Mailing address
1639 S CICERO AVE, CICERO, IL 60804-1520
(708) 477-6717
(708) 477-6434
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
1184826174
IL
1223G0001X
General Practice Dentistry
Primary
1710977939
IL
Other
Enumeration date
01/10/2018
Last updated
05/23/2022
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