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Organization

FAMILY SMILES P.C.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ALI NEMATOLLAHI D.D.S. (VICE-PRESIDENT)
(773) 866-0041
Entity
Organization

Contact information

Practice address
5240 N PULASKI RD, SUITE I, CHICAGO, IL 60630-1750
(773) 866-0041
(773) 866-0045
Mailing address
5240 N PULASKI RD, SUITE I, CHICAGO, IL 60630-1750
(773) 866-0041
(773) 866-0045

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019022805
IL

Other

Enumeration date
05/23/2007
Last updated
08/04/2009
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