MEDICARE: REGEN SMILE STUDIO, PLLC

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
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1861213985
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGEN SMILE STUDIO, PLLC

Provider Business Mailing Address
First Line	:	2915 W BELMONT AVE APT 2B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-9770
Country	:	US
Telephone Number	:	847-971-0364
Fax Number	:

Provider Business Practice Location Address
First Line	:	3208 N LINCOLN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-1106
Country	:	US
Telephone Number	:	847-971-0364
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. ERIN F CHO
Credential	:	DMD
Telephone Number	:	847-971-0364

Provider Enumeration Date	:	10/21/2024
Last Update Date	:	10/21/2024

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Directions to “REGEN SMILE STUDIO, PLLC ” Practice Location

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