Organization
SMILE MORE DENTAL 3 CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMI MOHAMED DIAB DDS (OWNER)
(312) 451-7264
Entity
Organization
Contact information
Practice address
1480 N ORCHARD RD, #104, AURORA, IL 60506-7939
(630) 343-0543
Mailing address
1480 N ORCHARD RD, #104, AURORA, IL 60506-7939
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
019027963
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019027963
—
IL
Enumeration date
02/14/2016
Last updated
02/14/2016
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