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Organization
SMILE ON OF NORTH SHORE, PC
Active
Organization
SMILE ON OF NORTH SHORE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL PONCZA DDS. DABDSM (OWNER)
(224) 282-8939
Entity
Organization
Contact information
Practice address
707 LAKE COOK RD., SUITE 121, DEERFIELD, IL 60015
(224) 282-8939
(773) 337-4988
Mailing address
707 LAKE COOK RD., SUITE 121, DEERFIELD, IL 60015
(224) 282-8939
(773) 337-4988
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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