Dental Shine, Ltd
Clinic/Center, Dental in Cicero, IL. Organization (NPI-2).
NPI number1063685196
StatusActive
Last updated in NPPESApr 9, 2008
Details
- NPI
- 1063685196
- Entity type
- Organization (NPI-2)
- Legal business name
- Dental Shine, Ltd
- Organization subpart
- No
- Enumeration date
- Apr 9, 2008
- Last updated
- Apr 9, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | 019026154 | IL | Yes |
Practice location
2319 S Cicero AveCicero, IL 60804-2451
Phone 708-222-8995
Mailing address
2319 S Cicero AveCicero, IL 60804-2451
Authorized official
Firas F El-Muqdad
President
7082228995
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