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Organization

NSP DENTAL LLC

Active
Parent organization
NSP DENTAL LLC
Other names
NSP Dental LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
NSP DENTAL LLC
Authorized official
DR. NICHOLAS S POLITO DDS (DENTIST)
(847) 367-1133
Entity
Organization

Contact information

Practice address
1900 HOLLISTER DR STE 190, LIBERTYVILLE, IL 60048-5283
(847) 680-0975
Mailing address
998 CASTLEWOOD CT, GURNEE, IL 60031-4106

Taxonomy

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

Other

Enumeration date
10/23/2020
Last updated
10/23/2020
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