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Organization

ISMILE DENTAL

Active
Organization subpart
No

Provider details

NPI number
Authorized official
YESENIA DELGADO (GENERAL MANAGER)
(773) 887-3244
Entity
Organization

Contact information

Practice address
4953 WEST FULLERTON AVE, CHICAGO, IL 60639
(773) 887-3244
(773) 897-6697
Mailing address
4953 W FULLERTON AVE, CHICAGO, IL 60639-2505
(773) 655-7455
(773) 897-6697

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-027782
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1437149622
IL
Enumeration date
09/01/2016
Last updated
09/01/2016
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