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Organization

DES PLAINES FAMILY DENTISTRY, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MYKOLA RUDYK (DENTIST)
(224) 255-5050
Entity
Organization

Contact information

Practice address
1695 ELK BLVD, DES PLAINES, IL 60016-4721
(773) 966-0505
(773) 966-0510
Mailing address
1695 ELK BLVD, DES PLAINES, IL 60016-4721
(773) 966-0505
(773) 966-0510

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Enumeration date
04/12/2021
Last updated
04/12/2021
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