Fantastic Smiles Ltd.
NPI #1104254630 in Mt Prospect, Illinois
Provider Information
- NPI Number
- 1104254630
- Entity Type
- Organization
- Organization Name
- Fantastic Smiles Ltd.
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Oct 18, 2013
- Last Updated
- Oct 18, 2013
Practice Location
- Address
- 250 W KENSINGTON RD
- Address 2
- SUITE 2A
- City
- Mt Prospect
- State
- Illinois
- ZIP Code
- 60056-1293
- Phone
- (847) 577-5464
Authorized Official
- Name
- DR. EWA KOSER, DDS
- Title
- PRESIDENT
- Phone
- (847) 577-5464
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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