Individual
MR. SAM TAHBAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1504 N WELLS STREET, CHICAGO, IL 60610
(312) 573-0007
Mailing address
1504 N. WELLS STREET, CHICAGO, IL 60160
(312) 573-0007
(312) 573-0002
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-024892
IL
Other
Enumeration date
11/02/2015
Last updated
11/02/2015
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