North Shore Dental Associates

NPI #1407108251 in Evanston, Illinois

Provider Information

NPI Number: 1407108251
Entity Type: Organization
Organization Name: North Shore Dental Associates
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 3, 2012
Last Updated: Oct 3, 2012

Practice Location

Address: 636 CHURCH ST
Address 2: #322
City: Evanston
State: Illinois
ZIP Code: 60201-4508
Phone: (847) 475-4544

Authorized Official

Name: DR. STAMATA BLANAS, DDS
Title: OWNER
Phone: (847) 475-4544

Specialties & Taxonomy Codes

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

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