Organization
MILLENNIUM PARK SMILES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHRISTOS D BABOULAS DDS (PRESIDENT)
(312) 263-7200
Entity
Organization
Contact information
Practice address
25 E WASHINGTON, SUITE 1707, CHICAGO, IL 60602
(312) 263-7200
Mailing address
25 E WASHINGTON ST, SUITE 1707, CHICAGO, IL 60602
(312) 263-7200
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019020154
IL
1223G0001X
General Practice Dentistry
Primary
019020453
IL
1223G0001X
General Practice Dentistry
—
IL
Other
Enumeration date
12/03/2012
Last updated
12/03/2012
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