Organization Name: | SMILES PAR EXCELLENCE PC |
NPI Number: | 1477534329 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | HANY YOUSSEF MOHAMED (DDS) |
Mailing Address: | 9830 Ridgeland Ave Chicago Ridge |
State: | IL US |
Postal Code: | 604152667 |
Phone Number: | 7086366424 |
Fax Number: | 7086366424 |
NPI Enumeration Date: | 11/08/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |