Organization
YOUR SMILE BY DESIGN, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID INGALLINERA D.D.S. (PRESIDENT)
(773) 327-6692
Entity
Organization
Contact information
Practice address
3939 W FULLERTON AVE, CHICAGO, IL 60647-2243
(773) 235-0000
Mailing address
1635 W BELMONT AVE, UNIT 708, CHICAGO, IL 60657-3047
(773) 327-6692
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
019025292
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1004771
—
IL
Enumeration date
04/11/2008
Last updated
04/15/2008
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