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Organization
AGNIESZKA IWASZCZYSZYN DMD PC
Active
Organization
AGNIESZKA IWASZCZYSZYN DMD PC
Active
Other names
Hart Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AGNIESZKA IWASZCZYSZYN DMD (PRESIDENT)
(708) 291-0354
Entity
Organization
Contact information
Practice address
728 W NORTHWEST HWY, BARRINGTON, IL 60010-2640
(847) 865-4278
Mailing address
491 LESLIE CT APT 201, DES PLAINES, IL 60016-8817
(708) 291-0354
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019030692
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1821441312
—
IL
Enumeration date
08/09/2018
Last updated
08/09/2018
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