Organization
ENVISION A SMILE INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICK BRAR (OWNER)
(630) 883-0111
Entity
Organization
Contact information
Practice address
2019 DEAN ST, ST CHARLES, IL 60174-4801
(630) 883-0111
Mailing address
2019 DEAN ST, ST CHARLES, IL 60174-4801
(630) 883-0111
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
11/10/2016
Last updated
11/10/2016
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