Countryside Dental Group, PC
NPI #1265812507 in Countryside, Illinois
Provider Information
- NPI Number
- 1265812507
- Entity Type
- Organization
- Organization Name
- Countryside Dental Group, PC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Jun 2, 2015
- Last Updated
- Aug 19, 2015
Practice Location
- Address
- 6335 JOLIET RD
- Address 2
- 200
- City
- Countryside
- State
- Illinois
- ZIP Code
- 60525-7427
- Phone
- (708) 352-1830
Authorized Official
- Name
- DR. LEILA SHAHBANDAR, D.D.S.
- Title
- PRESIDENT
- Phone
- (312) 498-2937
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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