| Sokolov Dental Ltd, Dba Hollywood Smile, Ltd | |
|
6439 N Cicero Ave Lincolnwood IL 60712-3407 | |
| (773) 316-7816 | |
| Not Available |
| Full Name | Sokolov Dental Ltd, Dba Hollywood Smile, Ltd |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 6439 N Cicero Ave, Lincolnwood, Illinois |
| Authorized Official Name and Position | Inna Sokolov (PRESIDENT) |
| Authorized Official Contact | 7733701900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Sokolov Dental Ltd, Dba Hollywood Smile, Ltd 6439 N Cicero Ave Lincolnwood IL 60712-3407 Ph: (773) 316-7816 | Sokolov Dental Ltd, Dba Hollywood Smile, Ltd 6439 N Cicero Ave Lincolnwood IL 60712-3407 Ph: (773) 316-7816 |
| NPI Number | 1962078287 |
|---|---|
| Provider Enumeration Date | 05/27/2021 |
| Last Update Date | 05/27/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962078287 | NPI | - | NPPES |
| 1235781956 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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