Organization
KLEAN SMILES SOUTHPORT PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NILAY PATEL DDS (OWNER)
(269) 348-5758
Entity
Organization
Contact information
Practice address
3712 N SOUTHPORT AVE, CHICAGO, IL 60613-6889
(269) 348-5758
Mailing address
3712 N SOUTHPORT AVE, CHICAGO, IL 60613-6889
(269) 348-5758
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
06/09/2025
Last updated
12/12/2025
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