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NPI Code Detail

MEDICARE: PERFECT SMILE P.C.

MEDICARE: PERFECT SMILE P.C.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist

General Provider Information

NPI Number : 1013188465
Entity Type Code : Organization
Provider Name (Legal Business Name) : PERFECT SMILE P.C.
Provider Business Mailing Address
First Line : 1624 W MONTROSE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60613-1214
Country : US
Telephone Number : 773-275-5600
Fax Number : 773-275-5868
Provider Business Practice Location Address
First Line : 3147 W CERMAK RD
Second Line :
City : CHICAGO
State : IL
Zip : 60623-3307
Country : US
Telephone Number : 773-352-1216
Fax Number :
Authorized Official
Title or Position : DENTIST
Name : DR. SALMAAN UMAR
Credential : DDS
Telephone Number : 773-275-5600
Provider Enumeration Date : 03/13/2008
Last Update Date : 03/17/2008

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Directions to “PERFECT SMILE P.C. ” Practice Location

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