Organization
AMDENTAL INC
Active
Other names
lifetime dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANNIE MIRZA DDS (OWNER)
(415) 890-6337
Entity
Organization
Contact information
Practice address
1421 N LEWIS AVE, WAUKEGAN, IL 60085-1757
(415) 890-6337
Mailing address
5845 W FOSTER AVE, CHICAGO, IL 60630-4635
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
06/12/2018
Last updated
06/12/2018
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