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Organization
TEETH BOUTIQUE PLLC
Active
Organization
TEETH BOUTIQUE PLLC
Active
Other names
Teeth Boutique
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RIZWANA MASKATIYA (OWNER)
(773) 857-2280
Entity
Organization
Contact information
Practice address
1933 W IRVING PARK RD STE 1, CHICAGO, IL 60613-5182
(773) 857-2280
(773) 857-2260
Mailing address
1933 W IRVING PARK RD STE 1, CHICAGO, IL 60613-5182
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
09/12/2024
Last updated
09/13/2024
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