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General NPI Number Information
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NPI Number | 1003304908
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Entity Type | Organization
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Legal Business Name | WORLD CLASS SMILES CHICAGO
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Dates
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Enumeration Date | 04/25/2018
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Last Update Date | 04/25/2018
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Provider Practice Location Address
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Address Line | 4801 W PETERSON AVE STE 316
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City | CHICAGO
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State | IL
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Zip | 60646-5726
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Country | US
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Telephone | 773-685-9666
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Fax | 773-685-1967
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Provider Business Mailing Address
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Address Line | 4801 W PETERSON AVE STE 316
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City | CHICAGO
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State | IL
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Zip | 60646-5726
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Country | US
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Telephone | 773-685-9666
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Fax | 773-685-1967
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Authorized Official
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Title or Position | DENTIST
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Name | DR. HAROLD J KRINSKY
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Credential | DDS
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Telephone | 773-685-9666
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 019016416
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License Number State | IL
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