Organization
MY SMILES DENTAL CENTER CRESCENT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HIDAYATHULLA KHAN D.M.D (PRESIDENT)
(224) 766-9876
Entity
Organization
Contact information
Practice address
307 S MILWAUKEE AVE STE 101, WHEELING, IL 60090-5035
(847) 306-5574
(847) 789-7193
Mailing address
307 S MILWAUKEE AVE STE 101, WHEELING, IL 60090-5035
(847) 306-5574
(847) 789-7193
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/17/2022
Last updated
06/17/2022
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