Organization
KISS DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHESTER PAUL KLOS DDS (PRESIDENT)
(773) 622-3454
Entity
Organization
Contact information
Practice address
5841 W BELMONT AVE, CHICAGO, IL 60634-5201
(773) 622-3454
(773) 622-0990
Mailing address
5841 W BELMONT AVE, CHICAGO, IL 60634-5201
(773) 622-3454
(773) 622-0990
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.017535
IL
1223G0001X
General Practice Dentistry
019.027916
IL
Other
Enumeration date
11/13/2010
Last updated
04/01/2015
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