# STONY ISLAND DENTAL PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427527365
- **Authorized official:** YAQIN DAWOUD DDS (DDS/OWNER)
- **Authorized official phone:** (708) 351-4562

## Contact information

- **Practice address:** 1600 E 93RD STREET, CHICAGO, IL 60617
- **Practice address phone:** (708) 351-4582
- **Mailing address:** 1600 E 93RD STREET, CHICAGO, IL 60617
- **Mailing address phone:** (708) 351-4582

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 11/21/2018
- **Last updated:** 11/21/2018