Organization
HICHAM RIBA DDS P.C.
Active
Other names
Dental Magic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALICIA C KIEFFER (OPERATIONS MANAGER)
(708) 819-0515
Entity
Organization
Contact information
Practice address
2556 W NORTH AVE, CHICAGO, IL 60647
(773) 360-1281
(773) 360-1285
Mailing address
2556 W NORTH AVE, CHICAGO, IL 60647
(773) 360-1281
(773) 360-1285
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019024373
IL
1223G0001X
General Practice Dentistry
019024373
IL
Other
Enumeration date
07/15/2011
Last updated
11/08/2013
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