| Chicago Dental Boutique | |
|
333 E Benton Pl Ste 202 Chicago IL 60601-7411 | |
| (312) 868-0301 | |
| Not Available |
| Full Name | Chicago Dental Boutique |
|---|---|
| Speciality | Dentist |
| Location | 333 E Benton Pl Ste 202, Chicago, Illinois |
| Authorized Official Name and Position | Rohi Atassi (DENTIST) |
| Authorized Official Contact | 3128680301 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Dental Boutique 333 E Benton Pl Ste 202 Chicago IL 60601-7411 Ph: (312) 868-0301 | Chicago Dental Boutique 333 E Benton Pl Ste 202 Chicago IL 60601-7411 Ph: (312) 868-0301 |
| NPI Number | 1043720907 |
|---|---|
| Provider Enumeration Date | 10/05/2017 |
| Last Update Date | 10/05/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043720907 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019030540 (Illinois) | Primary |
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