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General NPI Number Information
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NPI Number | 1093025223
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Entity Type | Organization
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Legal Business Name | ALL BRITE DENTAL S.C.
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Dates
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Enumeration Date | 10/21/2010
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Last Update Date | 10/21/2010
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Provider Practice Location Address
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Address Line | 1858 W 35TH ST
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City | CHICAGO
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State | IL
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Zip | 60609-1201
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Country | US
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Telephone | 773-247-5554
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Fax | 773-247-8272
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Provider Business Mailing Address
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Address Line | 1858 W 35TH ST
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City | CHICAGO
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State | IL
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Zip | 60609-1201
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Country | US
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Telephone | 773-247-5554
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Fax | 773-247-8272
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Authorized Official
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Title or Position | PRESIDENT
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Name | BHARAT SHETH
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Credential | D.D.S
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Telephone | 773-247-5554
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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 | 019018030
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License Number State | IL
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