PERIODONTAL MEDICINE AND SURGICAL SPECIALISTS LLC NPI 1386098390

NPI Information

PERIODONTAL MEDICINE AND SURGICAL SPECIALISTS, LLC is a periodontics dentist in Chicago, IL. The provider is that specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. PERIODONTAL MEDICINE AND SURGICAL SPECIALISTS, LLC NPI is 1386098390. The provider is registered as an organization entity type and is a multiple single specialty group.
The provider Former Legal Business Name Is Periodontal Medicine And Surgical Specialists, Ltd.

The provider's business location address is:

1009 W WEBSTER AVE
CHICAGO, IL
ZIP 60614-502
Phone: (630) 627-3930

The provider's authorized official is George Mandelaris .
The authorized official title is President and has the following contact phone number (630) 627-3930.

The enumeration date for this NPI number is 4/15/2016 and was last updated on 12/23/2016.

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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