Organization
SAHLOUL DENTAL, LLC
Active
Other names
Confident Smiles Dental Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MONA MANN (CREDENTIALING MANAGER)
(630) 697-8105
Entity
Organization
Contact information
Practice address
9830 RIDGELAND AVE STE 5, CHICAGO RIDGE, IL 60415-2668
(708) 636-6424
Mailing address
9830 RIDGELAND AVE STE 5, CHICAGO RIDGE, IL 60415-2668
(708) 636-6424
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100088321
—
WI
Enumeration date
01/18/2021
Last updated
01/18/2021
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