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Organization
THE DENTAL SPECIALSITS
Active
Organization
THE DENTAL SPECIALSITS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJAN SHARMA (OWNER)
(312) 915-0535
Entity
Organization
Contact information
Practice address
1 E SCOTT ST, CHICAGO, IL 60610-2372
(312) 915-0535
Mailing address
1 E SCOTT ST, CHICAGO, IL 60610-2372
(312) 915-0535
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
021001569
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021-001569
IL
Other
Enumeration date
02/12/2009
Last updated
02/12/2009
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