School House Dental Service

NPI #1104081884 in Chicago, Illinois

Provider Information

NPI Number: 1104081884
Entity Type: Organization
Organization Name: School House Dental Service
Primary Specialty: Dentist
Enumeration Date: Jul 22, 2008
Last Updated: Jul 22, 2008

Practice Location

Address: 2000 W 95TH ST
City: Chicago
State: Illinois
ZIP Code: 60643-1116
Phone: (773) 881-3911

Authorized Official

Name: DR. JERROLD W. SMITH, D.D.S.
Title: PRESIDENT
Phone: (773) 881-3911

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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