Organization
ADVANCED DENTAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FATEMEH KHAGHANI DDS (DENTIST)
(773) 871-0336
Entity
Organization
Contact information
Practice address
2457 N LINCOLN AVE, CHICAGO, IL 60614-8509
(773) 871-0336
(773) 871-0981
Mailing address
2457 N LINCOLN AVE, CHICAGO, IL 60614-8509
(773) 871-0336
(773) 871-0981
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
IL
1223G0001X
General Practice Dentistry
Primary
—
IL
1223P0300X
Periodontics
—
IL
Other
Enumeration date
04/11/2011
Last updated
04/11/2011
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