Organization
AGARWAL DENTAL CLINIC
Active
Parent organization
ACCESS COMMUNITY HEALTH NETWORK
Organization subpart
Yes
Provider details
NPI number
Legal business name
ACCESS COMMUNITY HEALTH NETWORK
Authorized official
DONNA THOMPSON (CEO)
(773) 257-6770
Entity
Organization
Contact information
Practice address
1415 EMERALD AVE, CHICAGO HEIGHTS, IL 60411-3517
(708) 756-7384
Mailing address
1501 S CALIFORNIA AVE, CHICAGO, IL 60608-1732
(773) 257-6770
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
11/02/2006
Last updated
08/10/2007
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