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General NPI Number Information
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NPI Number | 1659136802
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Entity Type | Organization
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Legal Business Name | DENTAL ART OF SKOKIE, PLLC
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Dates
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Enumeration Date | 02/16/2024
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 4235 MAIN ST
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City | SKOKIE
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State | IL
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Zip | 60076-2063
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Country | US
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Telephone | 224-935-3903
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Fax | 224-935-3904
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Provider Business Mailing Address
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Address Line | 4235 MAIN ST
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City | SKOKIE
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State | IL
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Zip | 60076-2063
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Country | US
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Telephone | 224-935-3903
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Fax | 224-935-3904
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. DIANA RIHANI
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Credential |
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Telephone | 224-935-3903
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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