Organization
KINTSUGI GROUP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LUIS PERALTA DMD (OWNER)
(917) 742-4608
Entity
Organization
Contact information
Practice address
1879 N MILWAUKEE AVE STE 1, CHICAGO, IL 60647-5689
(312) 429-6506
Mailing address
1879 N MILWAUKEE AVE STE 1, CHICAGO, IL 60647-5689
(312) 429-6506
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/09/2026
Last updated
03/09/2026
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