| Smile On Of North Shore, Pc | |
|
707 Lake Cook Rd. Suite 121 Deerfield IL 60015 | |
| (224) 282-8939 | |
| (773) 337-4988 |
| Full Name | Smile On Of North Shore, Pc |
|---|---|
| Speciality | Durable Medical Equipment & Medical Supplies |
| Location | 707 Lake Cook Rd., Deerfield, Illinois |
| Authorized Official Name and Position | Paul Poncza (OWNER) |
| Authorized Official Contact | 2242828939 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smile On Of North Shore, Pc 707 Lake Cook Rd. Suite 121 Deerfield IL 60015 Ph: (224) 282-8939 | Smile On Of North Shore, Pc 707 Lake Cook Rd. Suite 121 Deerfield IL 60015 Ph: (224) 282-8939 |
| NPI Number | 1891264644 |
|---|---|
| Provider Enumeration Date | 11/21/2018 |
| Last Update Date | 11/21/2018 |
| Medicare PECOS PAC ID | 8123457611 |
|---|---|
| Medicare Enrollment ID | O20200403002429 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891264644 | NPI | - | NPPES |
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