Organization
JOHN R. BIANCALANA, DDS LTD.
Active
Other names
Shawnway Plaza Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN ROBERT BIANCALANA DDS (OWNER/DENTIST/PRESIDENT)
(847) 985-5552
Entity
Organization
Contact information
Practice address
640 MEACHAM RD, ELK GROVE VILLAGE, IL 60007-3003
(847) 985-5552
(847) 985-9049
Mailing address
640 MEACHAM RD, ELK GROVE VILLAGE, IL 60007-3003
(847) 985-5552
(847) 985-9049
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1225246929
INDIVIDUAL NPI
IL
Enumeration date
04/17/2008
Last updated
04/17/2008
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