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Organization
MICHAEL STABLEIN DDS, P.C.
Active
Organization
MICHAEL STABLEIN DDS, P.C.
Active
Other names
CScholtzDDSMStableinDDSandAssociates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROLINE SCHOLTZ D.D.S., M.S. (OWNER)
(773) 282-8800
Entity
Organization
Contact information
Practice address
5530 W MONTROSE AVE, CHICAGO, IL 60641-1330
(773) 282-8800
Mailing address
5530 W MONTROSE AVE, CHICAGO, IL 60641-1330
(773) 282-8800
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
021002179
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021002179
STATE OF ILLINOIS
IL
Enumeration date
11/09/2012
Last updated
11/09/2012
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