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General NPI Number Information
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NPI Number | 1669782736
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Entity Type | Organization
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Legal Business Name | MARIA SINIS DMD LTD
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Dates
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Enumeration Date | 10/07/2010
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Last Update Date | 10/07/2010
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Provider Practice Location Address
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Address Line | 6428 N CALIFORNIA AVE
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City | CHICAGO
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State | IL
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Zip | 60645-5209
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Country | US
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Telephone | 773-973-0531
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Fax | 773-262-9850
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Provider Business Mailing Address
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Address Line | 1120 MIDWAY RD
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City | NORTHBROOK
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State | IL
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Zip | 60062-3938
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Country | US
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Telephone | 224-213-7289
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Fax | 773-262-9850
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIA SINIS
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Credential | D.M.D.
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Telephone | 954-663-6804
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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 | DN19022
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 019028502
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License Number State | IL
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