Perfect Dental Smile, Ltd.

NPI #1104077692 in Chicago, Illinois

Provider Information

NPI Number: 1104077692
Entity Type: Organization
Organization Name: Perfect Dental Smile, Ltd.
Subpart: Yes (part of a larger organization)
Parent Organization: PERFECT DENTAL SMILE, LTS.
Primary Specialty: Dentist
Enumeration Date: Oct 2, 2008
Last Updated: Nov 10, 2009

Practice Location

Address: 2545 W PETERSON AVE
Address 2: SUITE 201
City: Chicago
State: Illinois
ZIP Code: 60659-4091
Phone: (773) 561-2808

Authorized Official

Name: DR. BUSHRA AHMED AL AZZAWI, D.D.S.
Title: DENTIST
Phone: (773) 561-2808

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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