Dental Magic North Ave, INC

NPI #1104274109 in Chicago, Illinois

Provider Information

NPI Number: 1104274109
Entity Type: Organization
Organization Name: Dental Magic North Ave, INC
Primary Specialty: Dentist - General Practice
Enumeration Date: May 31, 2016
Last Updated: May 31, 2016

Practice Location

Address: 2500 W NORTH AVE
City: Chicago
State: Illinois
ZIP Code: 60647-5202
Phone: (773) 360-1281

Authorized Official

Name: SAWSAN ASFOUR, DDS
Title: OWNER
Phone: (773) 360-1281

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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