Dental 360 Pulaski 67 LLC
Dentist in Chicago, IL. Organization (NPI-2).
NPI number1124857461
StatusActive
Last updated in NPPESJul 26, 2024
Details
- NPI
- 1124857461
- Entity type
- Organization (NPI-2)
- Legal business name
- Dental 360 Pulaski 67 LLC
- Organization subpart
- No
- Enumeration date
- Jul 26, 2024
- Certification date
- Jul 26, 2024
- Last updated
- Jul 26, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | – | – | Yes |
Other names
- Dental 360 Logan Square (Doing Business As)
Practice location
2314 N Milwaukee Ave Ste BChicago, IL 60647-2925
Phone 773-697-3164 · Fax 773-697-3696
Mailing address
2314 N Milwaukee Ave Ste BChicago, IL 60647-2925
Phone 773-697-3164 · Fax 773-697-3696
Authorized official
Mohammed Parvez
Owner
6302941770
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