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Organization
NORTH SHORE SMILE STUDIO LLC
Active
Organization
NORTH SHORE SMILE STUDIO LLC
Active
Other names
Water Tower Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL ANESZKO DDS (PARTNER)
(312) 787-2131
Entity
Organization
Contact information
Practice address
845 N MICHIGAN AVE STE 951W, CHICAGO, IL 60611-2211
(312) 787-2131
Mailing address
845 N MICHIGAN AVE STE 951W, CHICAGO, IL 60611-2211
(312) 787-2131
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1245363332
NPI
IL
01
—
1861515595
NPI
—
Enumeration date
01/03/2022
Last updated
01/03/2022
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