| Familia Dental | |
|
200 W Lake St Addison IL 60101-2513 | |
| (888) 988-4066 | |
| (847) 496-7202 |
| Full Name | Familia Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 200 W Lake St, Addison, Illinois |
| Authorized Official Name and Position | Koushan Azad (PRESIDENT) |
| Authorized Official Contact | 8889884066 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Familia Dental 2050 E Algonquin Rd 610 Schaumburg IL 60173-4144 Ph: (888) 988-4066 | Familia Dental 200 W Lake St Addison IL 60101-2513 Ph: (888) 988-4066 |
| NPI Number | 1699049221 |
|---|---|
| Provider Enumeration Date | 02/29/2012 |
| Last Update Date | 02/29/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699049221 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019026920 (Illinois) | Primary |
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