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General NPI Number Information
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NPI Number | 1831985928
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Entity Type | Organization
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Legal Business Name | MR TEETH DENTAL AND IMPLANT CO.
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 05/25/2025
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Provider Practice Location Address
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Address Line | 552 S WASHINGTON ST STE 220
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City | NAPERVILLE
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State | IL
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Zip | 60540-6670
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Country | US
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Telephone | 617-380-8663
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Fax | 708-527-0656
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Provider Business Mailing Address
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Address Line | 3203 111TH ST APT 107
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City | NAPERVILLE
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State | IL
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Zip | 60564-0006
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Country | US
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Telephone | 617-380-8663
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Fax | 617-380-8663
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. HATEM GELANI IX
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Credential | DDS
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Telephone | 617-380-8663
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223P0700X
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Taxonomy Name | Prosthodontics
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License Number |
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License Number State |
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