# EZ DENTAL

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1104284710
- **Authorized official:** ABDUL MAJZOUB (BOSS)
- **Authorized official phone:** (773) 583-4455

## Contact information

- **Practice address:** 5621 W.MONTROSE AVENUE, CHICAGO, IL 60634
- **Practice address phone:** (773) 427-1000
- **Mailing address:** 5621 W.MONTROSE AVE, CHICAGO, IL 60634
- **Mailing address phone:** (773) 427-1000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 292200000X | Dental Laboratory | 019023027 | IL | Yes |

## Other

- **Enumeration date:** 02/10/2016
- **Last updated:** 02/10/2016