Organization
PARK WEST FAMILY DENTISTRY, PC
Active
Parent organization
PARK WEST FAMILY DENTISTRY, PC
Other names
Harmony Family Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
PARK WEST FAMILY DENTISTRY, PC
Authorized official
DR. FARIHA SIDDIQUI IMAM D.D.S. (DENTIST/OWNER)
(773) 880-6054
Entity
Organization
Contact information
Practice address
4909 W DIVISION ST, #409, CHICAGO, IL 60651-3161
(773) 378-4608
Mailing address
4909 W DIVISION ST, #409, CHICAGO, IL 60651-3161
(773) 378-4608
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027922
IL
Other
Enumeration date
07/24/2013
Last updated
07/24/2013
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