Calumet Park Dental Inc.

NPI #1174994479 in Calumet Park, Illinois

Provider Information

NPI Number: 1174994479
Entity Type: Organization
Organization Name: Calumet Park Dental Inc.
Primary Specialty: Dentist
Enumeration Date: Oct 13, 2015
Last Updated: Oct 13, 2015

Practice Location

Address: 1328 W 127TH ST
City: Calumet Park
State: Illinois
ZIP Code: 60827-6129
Phone: (708) 597-3131

Authorized Official

Name: SHAMEEMA ESSOF
Title: PRESIDENT
Phone: (630) 890-3123

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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