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Organization
PERFECT SMILE DENTAL SPA PARTNERSHIP
Active
Organization
PERFECT SMILE DENTAL SPA PARTNERSHIP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY B DOTSON DDS (DENTIST/PARTNER)
(773) 528-3384
Entity
Organization
Contact information
Practice address
2155 W. ROSCOE STREET, 1N, CHICAGO, IL 60618-6261
(773) 528-3384
(773) 528-3604
Mailing address
2155 W. ROSCOE STREET, 1N, CHICAGO, IL 60618-6261
(773) 528-3384
(773) 528-3604
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019020240
IL
1223G0001X
General Practice Dentistry
019025986
IL
Other
Enumeration date
12/24/2008
Last updated
12/24/2008
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