Organization
BRIGHTSMILES PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. H. JOHNNY I KUTTAB D.D.S. (PEDIATRIC DENTISTRY)
(847) 971-8847
Entity
Organization
Contact information
Practice address
2550 W ADDISON ST STE A17, CHICAGO, IL 60618-5939
(773) 423-6050
Mailing address
2550 W ADDISON ST STE A17, CHICAGO, IL 60618-5939
(773) 423-6050
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019.027640
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811155096
INDIVIDUAL NPI
IL
Enumeration date
07/20/2010
Last updated
02/16/2022
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