| North Shore Dental Associates | |
|
636 Church St #322 Evanston IL 60201-4508 | |
| (847) 475-4544 | |
| (847) 475-4523 |
| Full Name | North Shore Dental Associates |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 636 Church St, Evanston, Illinois |
| Authorized Official Name and Position | Stamata Blanas (OWNER) |
| Authorized Official Contact | 8474754544 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Shore Dental Associates 636 Church St #322 Evanston IL 60201-4508 Ph: (847) 475-4544 | North Shore Dental Associates 636 Church St #322 Evanston IL 60201-4508 Ph: (847) 475-4544 |
| NPI Number | 1407108251 |
|---|---|
| Provider Enumeration Date | 10/03/2012 |
| Last Update Date | 10/03/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407108251 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019021639 (Illinois) | Primary |
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