| Blue Star Dental Inc | |
|
4703 W Lawrence Ave Chicago IL 60630-1722 | |
| (773) 698-5773 | |
| Not Available |
| Full Name | Blue Star Dental Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 4703 W Lawrence Ave, Chicago, Illinois |
| Authorized Official Name and Position | Dorina Nastase (DENTIST) |
| Authorized Official Contact | 7736985773 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blue Star Dental Inc 5711 N Kimball Ave Apt 1n Chicago IL 60659-4523 Ph: (773) 698-5773 | Blue Star Dental Inc 4703 W Lawrence Ave Chicago IL 60630-1722 Ph: (773) 698-5773 |
| NPI Number | 1144765777 |
|---|---|
| Provider Enumeration Date | 01/06/2017 |
| Last Update Date | 01/06/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144765777 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019030349 (Illinois) | Primary |
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