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Organization

PARK WEST FAMILY DENTISTRY

Active
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Organization

PARK WEST FAMILY DENTISTRY

Active
Other names
Harmony Family Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. FARIHA SIDDIQUI IMAM D.D.S. (DENTIST/OWNER)
(773) 880-6054
Entity
Organization

Contact information

Practice address
830 W DIVERSEY PKWY, 2ND FLOOR, CHICAGO, IL 60614-1454
(773) 880-6054
Mailing address
830 W DIVERSEY PKWY, 2ND FLOOR, CHICAGO, IL 60614-1454
(773) 880-6054

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.027922
IL

Other

Enumeration date
01/10/2011
Last updated
01/03/2012
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