Organization
DENTAL STARZ LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILYAS M AHMED (OWNER)
(630) 290-2023
Entity
Organization
Contact information
Practice address
4434A W FULLERTON AVE, CHICAGO, IL 60639-1932
(773) 486-6500
(773) 486-6556
Mailing address
4434A W FULLERTON AVE, CHICAGO, IL 60639-1932
(773) 486-6500
(773) 486-6556
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019026721
IL
Other
Enumeration date
09/13/2010
Last updated
09/13/2010
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