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Organization

NORTHLAKE DENTAL CLINIC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MOHAMMAD HASEEB ABBAS DDS (PRESIDENT)
(708) 345-6313
Entity
Organization

Contact information

Practice address
161 E NORTH AVE, NORTHLAKE, IL 60164
(708) 345-6313
(708) 345-6530
Mailing address
161 E NORTH AVE, NORTHLAKE, IL 60164
(708) 345-6313
(708) 345-6530

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary

Other

Enumeration date
06/02/2008
Last updated
06/02/2008
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