MODERN DENTAL OF LOGAN SQUARE LLC is a general practice dentist in Chicago, IL. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. MODERN DENTAL OF LOGAN SQUARE LLC NPI is 1639625437. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
2645 N MILWAUKEE CHICAGO, IL ZIP 60647 Phone: (773) 717-5509
The provider's authorized official is Phillip Palella . The authorized official title is Owner and has the following contact phone number (773) 489-5700.
The enumeration date for this NPI number is 8/31/2016 and was last updated on 8/31/2016.
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:
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: 3/30/2025
NPI Synchronization or Removal
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