Organization
PARK RIDGE ENDODONTICS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICK I FITZGERALD DDS (PRESIDENT)
(847) 823-4161
Entity
Organization
Contact information
Practice address
350 S NORTHWEST HWY, SUITE 116, PARK RIDGE, IL 60068-4216
(847) 823-4161
(847) 823-4163
Mailing address
350 S NORTHWEST HWY, SUITE 116, PARK RIDGE, IL 60068-4216
(847) 823-4161
(847) 823-4163
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
060009606
IL
305R00000X
Preferred Provider Organization
Primary
060009606
IL
Other
Enumeration date
02/16/2010
Last updated
02/16/2010
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