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General NPI Number Information
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NPI Number | 1992870455
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Entity Type | Organization
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Legal Business Name | GLOBAL DENTAL CARE, P.C.
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 09/09/2013
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Provider Practice Location Address
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Address Line | 3666 W IRVING PARK RD
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City | CHICAGO
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State | IL
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Zip | 60618-4132
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Country | US
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Telephone | 773-478-1500
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Fax | 773-478-1926
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Provider Business Mailing Address
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Address Line | 3666 W IRVING PARK RD
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City | CHICAGO
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State | IL
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Zip | 60618-4132
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Country | US
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Telephone | 773-478-1500
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Fax | 773-478-1926
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Authorized Official
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Title or Position | OWNER
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Name | DR. SOGHRA MOJGAN SOROURI
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Credential | D.D.S.
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Telephone | 773-478-1500
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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 | 019024208
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License Number State | IL
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