Organization Name: | CUMBERLAND DENTAL ASSOCIATES, LTD. |
NPI Number: | 1043356926 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | WILLIAM T PARILLA (PRESIDENT) |
Mailing Address: | 4701 N Cumberland Ave Norridge |
State: | IL US |
Postal Code: | 607062905 |
Phone Number: | 7084521880 |
Fax Number: | 7084525004 |
NPI Enumeration Date: | 01/29/2007 |
NPI Last Update Date: | 04/11/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 06000309719014556 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |