| Fantastic Smiles Ltd. | |
|
250 W Kensington Rd Suite 2a Mt Prospect IL 60056-1293 | |
| (847) 577-5464 | |
| (847) 577-5474 |
| Full Name | Fantastic Smiles Ltd. |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 250 W Kensington Rd, Mt Prospect, Illinois |
| Authorized Official Name and Position | Ewa Koser (PRESIDENT) |
| Authorized Official Contact | 8475775464 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fantastic Smiles Ltd. 250 W Kensington Rd Suite 2a Mt Prospect IL 60056-1293 Ph: (847) 577-5464 | Fantastic Smiles Ltd. 250 W Kensington Rd Suite 2a Mt Prospect IL 60056-1293 Ph: (847) 577-5464 |
| NPI Number | 1104254630 |
|---|---|
| Provider Enumeration Date | 10/18/2013 |
| Last Update Date | 10/18/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104254630 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019-024294 (Illinois) | Primary |
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