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DENTAL DREAM TEAM ASSOCIATES LLC YETTA MCCULLOM SOLE MBR NPI 1972145183


NPI Information

NPI: 1972145183
Provider Name: DENTAL DREAM TEAM ASSOCIATES LLC YETTA MCCULLOM SOLE MBR
Classification: Dentist - 1223P0300X
Entity Type: Organization

Specialization: Periodontics

Address:
820 E 87TH ST STE 201
CHICAGO, IL
ZIP 60619
Phone: (773) 488-9072
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DENTAL DREAM TEAM ASSOCIATES LLC YETTA MCCULLOM SOLE MBR 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. DENTAL DREAM TEAM ASSOCIATES LLC YETTA MCCULLOM SOLE MBR NPI is 1972145183. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

820 E 87TH ST STE 201
CHICAGO, IL
ZIP 60619-256
Phone: (773) 488-9072
Fax: (888) 506-5697

The provider's authorized official is Yetta G Mccullom .
The authorized official title is Manager Sole Member and has the following contact phone number (773) 488-9072.

The enumeration date for this NPI number is 10/9/2019 and was last updated on 10/9/2019.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223P0300XDentistPeriodonticsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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