CITY KIDS DENTAL PC NPI 1013068972

NPI Information

CITY KIDS DENTAL, PC is a pediatric dentistry dentist in Chicago, IL. The provider is an age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. CITY KIDS DENTAL, PC NPI is 1013068972. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4700 N WESTERN AVE
SUITE 1A
CHICAGO, IL
ZIP 60625-081
Phone: (773) 293-2700
Fax: (773) 293-3854

The provider's authorized official is Mary Elizabeth Tierney .
The authorized official title is President and has the following contact phone number (773) 293-2700.

The enumeration date for this NPI number is 1/16/2007 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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