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Organization

YOUR SMILE BY DESIGN, P.C.

Active
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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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