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General NPI Number Information
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NPI Number | 1770211344
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Entity Type | Organization
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Legal Business Name | SMILE MORE DENTISTRY PLLC
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Dates
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Enumeration Date | 08/11/2022
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Last Update Date | 08/11/2022
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Provider Practice Location Address
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Address Line | 6257 N CLARK ST
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City | CHICAGO
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State | IL
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Zip | 60660-1201
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Country | US
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Telephone | 773-536-1155
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Fax |
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Provider Business Mailing Address
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Address Line | 6257 N CLARK ST
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City | CHICAGO
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State | IL
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Zip | 60660-1201
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | MALIHA KHAN
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Credential | DMD
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Telephone | 773-536-1155
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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 |
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License Number State |
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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 |
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License Number State |
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