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Organization
THE DENTAL LOFT, LLC
Active
Organization
THE DENTAL LOFT, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELHAM SHARAF-ELDEEN DMD (DENTIST)
(708) 482-0702
Entity
Organization
Contact information
Practice address
1 W HARRIS AVE, SECOND FLOOR, SUITE A, LA GRANGE, IL 60525-2496
(708) 482-0702
Mailing address
1 W HARRIS AVE, SUITE 2A, LA GRANGE, IL 60525-2496
(708) 482-0702
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.027663
IL
122300000X
Dentist
Primary
019.028065
IL
Other
Enumeration date
01/13/2012
Last updated
08/03/2015
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