Provider Demographics
NPI:1306514773
Name:FAMILY DENTAL CARE
Entity type:Organization
Organization Name:FAMILY DENTAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSOCIATE
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GIULIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:708-280-7341
Mailing Address - Street 1:3009 E 92ND ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60617-4502
Mailing Address - Country:US
Mailing Address - Phone:773-295-2521
Mailing Address - Fax:
Practice Address - Street 1:3009 E 92ND ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-4502
Practice Address - Country:US
Practice Address - Phone:773-295-2521
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223D0001XDental ProvidersDentistDental Public HealthGroup - Multi-Specialty