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Organization
STONY ISLAND DENTAL PC
Active
Organization
STONY ISLAND DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
YAQIN DAWOUD DDS (DDS/OWNER)
(708) 351-4562
Entity
Organization
Contact information
Practice address
1600 E 93RD STREET, CHICAGO, IL 60617
(708) 351-4582
Mailing address
1600 E 93RD STREET, CHICAGO, IL 60617
(708) 351-4582
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
NULL
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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