Organization
BENJAMIN A. BAPTIST DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN A BAPTIST DDS (PRESIDENT/CEO)
(708) 442-7414
Entity
Organization
Contact information
Practice address
2530 BURR OAK AVE, NORTH RIVERSIDE, IL 60546-1515
(708) 442-7414
Mailing address
2530 BURR OAK AVE, NORTH RIVERSIDE, IL 60546-1515
(708) 442-7414
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019027932
IL
Other
Enumeration date
11/21/2017
Last updated
11/21/2017
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