Organization
YOUR LIFESMILES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER T HARNOIS DDS (PRESIDENT)
(312) 944-5200
Entity
Organization
Contact information
Practice address
980 N MICHIGAN AVE, SUITE 1520, CHICAGO, IL 60611-4501
(312) 944-5200
(312) 944-0154
Mailing address
980 N MICHIGAN AVE, SUITE 1520, CHICAGO, IL 60611-4501
(312) 944-5200
(312) 944-0154
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
019018263
IL
Other
Enumeration date
01/16/2010
Last updated
01/16/2010
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