Modern Dental On Clark Street

LBN: Modern Dental On Clark Street
Modern Dental On Clark Street is an health care organization with primary practice located at 744 N Clark St , Chicago IL 60654-2525. The organization recently has 3 registered licenses in different health care specialties including Dental Providers / General Practice, Ambulatory Health Care Facilities / Dental, Managed Care Organizations / Preferred Provider Organization. Dental Providers / General Practice is the primary health care specialty. Modern Dental On Clark Street can be contacted via phone (773) 489-5700, or through Palella, Phillip via phone (773) 489-5700.

Contact Information

Primary practice address
744 N Clark St Chicago IL 60654-2525
Phone: (773) 489-5700
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Palella, Phillip Doctor of Dental Surgery (DDS)
Phone: (773) 489-5700

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X
Ambulatory Health Care Facilities / Dental 261QD0000X
Managed Care Organizations / Preferred Provider Organization 305R00000X

Profile Details

NPI number 1265962674
LBN Legal business name Modern Dental On Clark Street
DBA Doing business as
Authorized official Palella, Phillip Doctor of Dental Surgery (DDS)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 18th, 2017
Last updated Jun 18th, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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