Organization
KIMBERLY SMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL ANAST D.M.D. (DENTIST)
(773) 276-1047
Entity
Organization
Contact information
Practice address
1835 N MILWAUKEE AVE, CW, CHICAGO, IL 60647-6186
(773) 276-1047
Mailing address
1835 N MILWAUKEE AVE, CW, CHICAGO, IL 60647-6186
(773) 276-1047
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
1223E0200X
Endodontics
—
—
1223G0001X
General Practice Dentistry
—
—
1223P0221X
Pediatric Dentistry
—
—
1223P0300X
Periodontics
—
—
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
124Q00000X
Dental Hygienist
—
—
126800000X
Dental Assistant
—
—
Other
Enumeration date
05/21/2013
Last updated
05/21/2013
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