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General NPI Number Information
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NPI Number | 1013812239
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Entity Type | Organization
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Legal Business Name | SPECIALIST SMILE INC.
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Dates
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Enumeration Date | 10/08/2026
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Last Update Date | 10/08/2026
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Provider Practice Location Address
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Address Line | 8342 LEMONT RD STE 3F
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City | DARIEN
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State | IL
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Zip | 60561-1510
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Country | US
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Telephone | 630-581-0000
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Fax | 331-200-5020
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Provider Business Mailing Address
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Address Line | 8342 LEMONT RD STE 3F
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City | DARIEN
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State | IL
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Zip | 60561-1510
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Country | US
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Telephone | 630-581-0000
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Fax | 331-200-5020
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | ROSA MENDEZ
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Credential |
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Telephone | 630-581-0000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State | NULL
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