Organization
GREAT SMILES DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAIS RABADI (PRESIDENT/DENTIST)
(708) 715-0805
Entity
Organization
Contact information
Practice address
2410 W JEFFERSON ST STE 108, JOLIET, IL 60435-6451
(815) 744-4443
Mailing address
13075 S 80TH AVE, PALOS HEIGHTS, IL 60463-2466
(708) 715-0805
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
02/17/2020
Last updated
02/17/2020
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