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Organization
THE DENTAL SPECIALISTS
Active
Organization
THE DENTAL SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAJAN SHARMA (OWNER)
(773) 667-3636
Entity
Organization
Contact information
Practice address
1424 E 53RD ST, #209, CHICAGO, IL 60615-4500
(773) 667-3636
Mailing address
1424 E 53RD ST, #209, CHICAGO, IL 60615-4500
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
021-001569
IL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
021-001569
IL
Other
Enumeration date
06/05/2009
Last updated
06/05/2009
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