Organization
EAST ERIE DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NASRIN AZIMZADEH DMD (OWNER)
(312) 587-0200
Entity
Organization
Contact information
Practice address
233 E ERIE ST, SUITE 406, CHICAGO, IL 60611-2926
(312) 587-0200
Mailing address
233 E ERIE ST, SUITE 406, CHICAGO, IL 60611-2926
(312) 587-0200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019024883
IL
Other
Enumeration date
05/14/2008
Last updated
05/14/2008
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