Organization
CALUMET PARK DENTAL INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHAMEEMA ESSOF (PRESIDENT)
(630) 890-3123
Entity
Organization
Contact information
Practice address
1328 W 127TH ST, CALUMET PARK, IL 60827-6129
(708) 597-3131
(798) 597-1898
Mailing address
PO BOX 179, BLUE ISLAND, IL 60406-0179
(708) 597-3131
(708) 597-1898
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019023113
IL
Other
Enumeration date
10/13/2015
Last updated
10/13/2015
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