| Sahloul Dental, Llc | |
|
9830 Ridgeland Ave Ste 5 Chicago Ridge IL 60415-2668 | |
| (708) 636-6424 | |
| Not Available |
| Full Name | Sahloul Dental, Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 9830 Ridgeland Ave Ste 5, Chicago Ridge, Illinois |
| Authorized Official Name and Position | Mona Mann (CREDENTIALING MANAGER) |
| Authorized Official Contact | 6306978105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sahloul Dental, Llc 9830 Ridgeland Ave Ste 5 Chicago Ridge IL 60415-2668 Ph: (708) 636-6424 | Sahloul Dental, Llc 9830 Ridgeland Ave Ste 5 Chicago Ridge IL 60415-2668 Ph: (708) 636-6424 |
| NPI Number | 1679163208 |
|---|---|
| Provider Enumeration Date | 01/18/2021 |
| Last Update Date | 01/18/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679163208 | NPI | - | NPPES |
| 100088321 | Medicaid | WI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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