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General NPI Number Information
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NPI Number | 1558483180
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Entity Type | Organization
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Legal Business Name | GENTLE TOUCH FAMILY DENTISTRY
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 07/22/2008
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Provider Practice Location Address
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Address Line | 1450 GINGER WOODS CT
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City | WHEELING
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State | IL
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Zip | 60090-5401
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Country | US
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Telephone | 312-375-8860
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Fax |
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Provider Business Mailing Address
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Address Line | 1450 GINGER WOODS CT
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City | WHEELING
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State | IL
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Zip | 60090-5401
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Country | US
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Telephone | 312-375-8860
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SIMONA ALEXANDRA CHESKIS
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Credential | D.D.S.
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Telephone | 312-375-8860
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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 | 019026416
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License Number State | IL
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