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General NPI Number Information
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NPI Number | 1952574345
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Entity Type | Organization
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Legal Business Name | AMAZING TOUCH DENTAL CENTER
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Dates
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Enumeration Date | 04/08/2008
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Last Update Date | 04/08/2008
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Provider Practice Location Address
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Address Line | 1021 E SIBLEY BLVD
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City | DOLTON
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State | IL
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Zip | 60419-2836
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Country | US
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Telephone | 708-849-1999
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Fax | 708-849-9584
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Provider Business Mailing Address
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Address Line | 1021 E SIBLEY BLVD
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City | DOLTON
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State | IL
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Zip | 60419-2836
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Country | US
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Telephone | 708-849-1999
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Fax | 708-849-9584
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Authorized Official
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Title or Position | RECEPTIONIST
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Name | AISHA L NETTLES
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Credential |
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Telephone | 708-849-1999
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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 |
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License Number State | IL
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