Organization
A.E. ATTA, DDS MSD, MD LTD.
Active
Parent organization
A.E. ATTA, DDS MSD, MBA LTD.
Organization subpart
Yes
Provider details
NPI number
Legal business name
A.E. ATTA, DDS MSD, MBA LTD.
Authorized official
DR. AL E ATTA DDS, MSD, MBA (CEO)
(847) 295-2855
Entity
Organization
Contact information
Practice address
400 LAKE-COOK RD., DEERFIELD, IL 60015
(847) 945-2290
(847) 945-2380
Mailing address
1901 SURREY LANE, LAKE FOREST, IL 60045
(847) 945-2290
(847) 945-2380
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.014011
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
012.000694
IL
Other
Enumeration date
02/18/2010
Last updated
02/18/2010
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