Smiles of Elgin P.c

NPI #1114296712 in Elgin, Illinois

Provider Information

NPI Number: 1114296712
Entity Type: Organization
Organization Name: Smiles of Elgin P.c
Primary Specialty: Dentist - General Practice
Enumeration Date: Dec 28, 2011
Last Updated: Dec 28, 2011

Practice Location

Address: 860 SUMMIT ST
Address 2: SUITE 134
City: Elgin
State: Illinois
ZIP Code: 60120-5145
Phone: (847) 695-3368

Authorized Official

Name: MR. PRASAD GONAVARUM, DDS
Title: OWNER
Phone: (847) 695-3368

Specialties & Taxonomy Codes

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

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