Organization
DENTAL STARZ 3 L.L.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMMED ASIM D.D.S (GENERAL DENTIST)
(708) 562-5100
Entity
Organization
Contact information
Practice address
1701 N LARKIN AVE, SUITE 504 A, CREST HILL, IL 60403-1970
(708) 562-5100
Mailing address
1701 N LARKIN AVE, SUITE 504 A, CREST HILL, IL 60403-1970
(708) 562-5100
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
06/16/2016
Last updated
06/16/2016
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