| Perfect Smile Dental Spa Partnership | |
|
2155 W. Roscoe Street, 1n Chicago IL 60618-6261 | |
| (773) 528-3384 | |
| (773) 528-3604 |
| Full Name | Perfect Smile Dental Spa Partnership |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2155 W. Roscoe Street, 1n, Chicago, Illinois |
| Authorized Official Name and Position | Timothy B Dotson (DENTIST/PARTNER) |
| Authorized Official Contact | 7735283384 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Perfect Smile Dental Spa Partnership 2155 W. Roscoe Street, 1n Chicago IL 60618-6261 Ph: (773) 528-3384 | Perfect Smile Dental Spa Partnership 2155 W. Roscoe Street, 1n Chicago IL 60618-6261 Ph: (773) 528-3384 |
| NPI Number | 1346486289 |
|---|---|
| Provider Enumeration Date | 12/24/2008 |
| Last Update Date | 12/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346486289 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019020240 (Illinois) | Primary |
| 1223G0001X | Dentist - General Practice | 019025986 (Illinois) | Secondary |
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