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Organization
SHINING SMILES 4, INC
Active
Organization
SHINING SMILES 4, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MILAD NOURAHMADI DDS (SECRETARY)
(312) 217-2223
Entity
Organization
Contact information
Practice address
110 N LARKIN AVE, JOLIET, IL 60435-6603
(630) 972-4010
Mailing address
210 N BOLINGBROOK DR, BOLINGBROOK, IL 60440-2386
(815) 310-3220
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019028115
IL
Other
Enumeration date
02/20/2017
Last updated
02/20/2017
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