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Organization

BEYOND SMILES OF PARK RIDGE

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Other names
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Organization subpart
No

Provider details

NPI number
Authorized official
DR. KERRY L LOWERY DDS (DENTIST)
(773) 771-2605
Entity
Organization

Contact information

Practice address
650 N NORTHWEST HWY STE E, PARK RIDGE, IL 60068-2554
(847) 292-2700
Mailing address
650 N NORTHWEST HWY STE E, PARK RIDGE, IL 60068-2554
(847) 292-2700

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1912019142
IL
Enumeration date
09/02/2019
Last updated
09/02/2019
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