Organization
NEW SMILE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINA POSKUS DDS (DDS GENERAL DENTIST)
(773) 735-7730
Entity
Organization
Contact information
Practice address
4635 W. 63RD STREET, SUITE D, CHICAGO, IL 60629
(773) 735-7730
Mailing address
4635 W. 63RD STREET, SUITE D, CHICAGO, IL 60629
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019-024853
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102597
—
IL
Enumeration date
10/08/2008
Last updated
10/15/2008
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