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Organization
DENTAL SHINE II, P, C.
Active
Organization
DENTAL SHINE II, P, C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FIRAS FALEH EL-MUQDAD (PRESIDENT)
(773) 847-4444
Entity
Organization
Contact information
Practice address
4719 S KEDZIE AVE, CHICAGO, IL 60632-3001
(773) 847-4444
Mailing address
4719 S KEDZIE AVE, CHICAGO, IL 60632-3001
(773) 847-4444
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019026154
IL
Other
Enumeration date
01/22/2009
Last updated
01/22/2009
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