| Blue Island Smiles Family Dentistry | |
|
12059 Western Avenue Blue Island IL 60406 | |
| () - | |
| Not Available |
| Full Name | Blue Island Smiles Family Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 12059 Western Avenue, Blue Island, Illinois |
| Authorized Official Name and Position | Abhishek Nagaraj (OWNER) |
| Authorized Official Contact | 7083713844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Island Smiles Family Dentistry 12059 Western Ave Blue Island IL 60406-1162 Ph: (708) 371-3844 | Blue Island Smiles Family Dentistry 12059 Western Avenue Blue Island IL 60406 Ph: () - |
| NPI Number | 1942842810 |
|---|---|
| Provider Enumeration Date | 10/12/2019 |
| Last Update Date | 08/24/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942842810 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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