Organization
NORTHWESTERN DENTAL CLINIC LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALI EKTERA (PRESIDENT)
(773) 252-0033
Entity
Organization
Contact information
Practice address
2604 W NORTH AVE, CHICAGO, IL 60647-5235
(773) 252-0033
Mailing address
2604 W NORTH AVE, CHICAGO, IL 60647-5235
(773) 252-0033
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019023897
IL
Other
Enumeration date
02/25/2009
Last updated
02/25/2009
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