Organization
NORTHSHORE DENTAL PARTNERS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COLEEN-SHANNON LICAR (MANAGER)
(847) 864-8151
Entity
Organization
Contact information
Practice address
2200 CENTRAL ST, EVANSTON, IL 60201-1416
(847) 869-7710
Mailing address
2200 CENTRAL ST, EVANSTON, IL 60201-1416
(847) 869-7710
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/28/2023
Last updated
09/28/2023
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