Organization
BEVERLY SHORES SMILE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. KRISTINE KOWALSKI (OFFICE MANAGER)
(773) 233-3535
Entity
Organization
Contact information
Practice address
10142 S WESTERN AVE, CHICAGO, IL 60643-1928
(773) 233-3535
(773) 238-5713
Mailing address
10142 S WESTERN AVE, CHICAGO, IL 60643-1928
(773) 233-3535
(773) 238-5713
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
IL
Other
Enumeration date
10/11/2006
Last updated
08/22/2020
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