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Organization
SMILE360CHICAGO
Active
Organization
SMILE360CHICAGO
Active
Other names
smile360chicago
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MUSTAFA SALAM DMD (DENTIST/OWNER)
(773) 338-7565
Entity
Organization
Contact information
Practice address
2836 W DEVON AVE, CHICAGO, IL 60659-1513
(773) 338-7565
Mailing address
2836 W DEVON AVE, CHICAGO, IL 60659-1513
(773) 338-7565
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
03/13/2020
Last updated
03/13/2020
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