| Shaan Dental Llc | |
|
5917 S Pulaski Rd Chicago IL 60629-4515 | |
| (708) 439-4655 | |
| Not Available |
| Full Name | Shaan Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 5917 S Pulaski Rd, Chicago, Illinois |
| Authorized Official Name and Position | Shaan Ankola (SOLE MEMBER) |
| Authorized Official Contact | 7087452758 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaan Dental Llc 15551 Dewberry Ln Orland Park IL 60462-7719 Ph: (708) 745-2758 | Shaan Dental Llc 5917 S Pulaski Rd Chicago IL 60629-4515 Ph: (708) 439-4655 |
| NPI Number | 1134751837 |
|---|---|
| Provider Enumeration Date | 02/10/2020 |
| Last Update Date | 02/10/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134751837 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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