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Organization
SMILES ON MICHIGAN
Active
Organization
SMILES ON MICHIGAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDRA BELTRAN (OFFICE MANAGER)
(312) 565-0014
Entity
Organization
Contact information
Practice address
155 N MICHIGAN AVE STE 323, CHICAGO, IL 60601-7511
(312) 565-0014
Mailing address
155 N MICHIGAN AVE STE 323, CHICAGO, IL 60601-7511
(312) 565-0014
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1144583550
DENTIST
IL
01
—
1962804401
ENDODONTICS SPECIALISTS
IL
Enumeration date
11/28/2018
Last updated
11/28/2018
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