Organization
DR. REYNOLDS COSMETIC DENTAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA REYNOLDS D.D.S. (DENTIST/PRESIDENT)
(708) 383-0500
Entity
Organization
Contact information
Practice address
101 MADISON ST, SUITE 301, OAK PARK, IL 60302-4278
(708) 383-0500
(708) 383-0800
Mailing address
PO BOX 2216, OAK PARK, IL 60303-2216
(708) 383-0500
(708) 383-0800
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019017700
IL
1223G0001X
General Practice Dentistry
019028628
IL
Other
Enumeration date
01/06/2012
Last updated
01/06/2012
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