Organization
MICHAEL STABLEIN DDS, P.C.
Active
Other names
CScholtzDDSMStableinDDSandAssociates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROLINE SCHOLTZ D.D.S., M.S. (OWNER)
(773) 282-8800
Entity
Organization
Contact information
Practice address
5530 W MONTROSE AVE, CHICAGO, IL 60641-1330
(773) 282-8800
Mailing address
5530 W MONTROSE AVE, CHICAGO, IL 60641-1330
(773) 282-8800
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
021002179
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021002179
STATE OF ILLINOIS
IL
Enumeration date
11/09/2012
Last updated
11/09/2012
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