Siri Chanthasalo, D.d.s., P.c.

NPI #1114178183 in Elgin, Illinois

Provider Information

NPI Number: 1114178183
Entity Type: Organization
Organization Name: Siri Chanthasalo, D.d.s., P.c.
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 8, 2008
Last Updated: Oct 8, 2008

Practice Location

Address: 3091 W. ROUTE 20
Address 2: #103
City: Elgin
State: Illinois
ZIP Code: 60124
Phone: (847) 841-1555

Authorized Official

Name: DR. SIRI CHANTHASALO, D.D.S.
Title: PRESIDENT
Phone: (847) 217-7215

Specialties & Taxonomy Codes

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

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