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Organization
TOOTHTOWN PLLC
Active
Organization
TOOTHTOWN PLLC
Active
Other names
Toothtown Dental Addison
Organization subpart
No
Provider details
NPI number
Authorized official
YUSUF FAHMY DMD (OWNER)
(630) 352-1547
Entity
Organization
Contact information
Practice address
303 W LAKE ST STE 300, ADDISON, IL 60101-2564
(630) 352-1547
Mailing address
1042 N YALE AVE, VILLA PARK, IL 60181-1146
(630) 352-1547
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019030794
—
IL
Enumeration date
07/15/2022
Last updated
07/15/2022
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