| Pristine Dental P C | |
|
159 N Neltnor Blvd Unit 100 West Chicago IL 60185-2315 | |
| (773) 398-5822 | |
| Not Available |
| Full Name | Pristine Dental P C |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 159 N Neltnor Blvd Unit 100, West Chicago, Illinois |
| Authorized Official Name and Position | Moeen Ikram (PRESIDENT) |
| Authorized Official Contact | 7733985822 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pristine Dental P C 159 N Neltnor Blvd Unit 100 West Chicago IL 60185-2315 Ph: (773) 398-5822 | Pristine Dental P C 159 N Neltnor Blvd Unit 100 West Chicago IL 60185-2315 Ph: (773) 398-5822 |
| NPI Number | 1851537104 |
|---|---|
| Provider Enumeration Date | 12/16/2008 |
| Last Update Date | 12/16/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851537104 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019026480 (Illinois) | Primary |
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