Organization
SMILE ON OF NORTH SHORE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL PONCZA DDS. DABDSM (OWNER)
(224) 282-8939
Entity
Organization
Contact information
Practice address
707 LAKE COOK RD., SUITE 121, DEERFIELD, IL 60015
(224) 282-8939
(773) 337-4988
Mailing address
707 LAKE COOK RD., SUITE 121, DEERFIELD, IL 60015
(224) 282-8939
(773) 337-4988
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
332BC3200X
Customized Equipment (DME)
Primary
—
—
Other
Enumeration date
11/21/2018
Last updated
11/21/2018
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