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General NPI Number Information
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NPI Number | 1013188465
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Entity Type | Organization
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Legal Business Name | PERFECT SMILE P.C.
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Dates
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Enumeration Date | 03/13/2008
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Last Update Date | 03/17/2008
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Provider Practice Location Address
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Address Line | 3147 W CERMAK RD
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City | CHICAGO
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State | IL
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Zip | 60623-3307
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Country | US
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Telephone | 773-352-1216
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Fax |
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Provider Business Mailing Address
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Address Line | 1624 W MONTROSE AVE
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City | CHICAGO
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State | IL
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Zip | 60613-1214
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Country | US
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Telephone | 773-275-5600
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Fax | 773-275-5868
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Authorized Official
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Title or Position | DENTIST
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Name | DR. SALMAAN UMAR
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Credential | DDS
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Telephone | 773-275-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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