Organization
DENTAL SMILES OF OAK FOREST PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISOULA GEORGACOULOS (D.M.D)
(708) 687-4256
Entity
Organization
Contact information
Practice address
6056 159TH ST, OAK FOREST, IL 60452-2904
(708) 687-4256
(708) 687-6559
Mailing address
6056 159TH ST, OAK FOREST, IL 60452-2904
(708) 687-4256
(708) 687-6559
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
363692279
IL
Other
Enumeration date
02/10/2012
Last updated
02/13/2012
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