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General NPI Number Information
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NPI Number | 1750632667
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Entity Type | Organization
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Legal Business Name | DUNDEE DENTAL SMILE PC
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Dates
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Enumeration Date | 10/02/2012
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Last Update Date | 10/02/2012
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Provider Practice Location Address
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Address Line | 27 SOUTH WESTERN AVE UNIT # E
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City | CARPENTERVILLE
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State | IL
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Zip | 60110
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Country | US
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Telephone | 312-608-0246
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Fax |
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Provider Business Mailing Address
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Address Line | 2505 W.SCHAUMBURG ROAD
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City | SCHAUMBURG
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State | IL
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Zip | 60194
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Country | US
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Telephone | 847-891-9999
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Fax | 847-891-9008
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KYUNG CHOI
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Credential | DMD
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Telephone | 312-608-0246
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 019027237
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License Number State | IL
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