Organization
OLD ORCHARD DENTAL GROUP P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ATOSA SARRAFI DMD (PRESIDENT)
(312) 402-7414
Entity
Organization
Contact information
Practice address
9631 GROSS POINT RD, SUITE 4, SKOKIE, IL 60076-1264
(312) 402-7414
Mailing address
9631 GROSS POINT RD, SUITE 4, SKOKIE, IL 60076-1264
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
IL
Other
Enumeration date
03/09/2010
Last updated
03/09/2010
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