Organization
D2 DENTAL AT OAK STREET, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BORIS LABINOV (AGENT)
(708) 445-2668
Entity
Organization
Contact information
Practice address
3046 WEST 127TH STREET, BLUE ISLAND, IL 60406
(312) 888-4306
Mailing address
137 N OAK PARK AVE, SUITE 310, OAK PARK, IL 60301-1344
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/29/2014
Last updated
07/29/2014
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