Provider Demographics
NPI:1699232017
Name:ORTHODONTIC EXPERTS LTD
Entity type:Organization
Organization Name:ORTHODONTIC EXPERTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MONIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:BZDAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-609-5007
Mailing Address - Street 1:17759 HALSTED ST
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2009
Mailing Address - Country:US
Mailing Address - Phone:708-405-2122
Mailing Address - Fax:
Practice Address - Street 1:17759 HALSTED ST
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2009
Practice Address - Country:US
Practice Address - Phone:708-405-2122
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ORTHODONTIC EXPERTS LTD
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty