West Loop Family Dental LLC

NPI #1073997722 in Chicago, Illinois

Provider Information

NPI Number: 1073997722
Entity Type: Organization
Organization Name: West Loop Family Dental LLC
Primary Specialty: Dentist
Enumeration Date: Jul 13, 2015
Last Updated: Oct 19, 2015

Practice Location

Address: 1202 W MADISON ST
City: Chicago
State: Illinois
ZIP Code: 60607-1908
Phone: (312) 724-7161

Authorized Official

Name: DR. ANKITA SHAH, DMD
Title: MANAGER
Phone: (818) 324-3315

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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