| Shining Smiles 4, Inc | |
| 
					110 N Larkin Ave Joliet IL 60435-6603  | |
| (630) 972-4010 | |
| Not Available | 
| Full Name | Shining Smiles 4, Inc | 
|---|---|
| Speciality | Dentist - General Practice | 
| Location | 110 N Larkin Ave, Joliet, Illinois | 
| Authorized Official Name and Position | Milad Nourahmadi (SECRETARY) | 
| Authorized Official Contact | 3122172223 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Shining Smiles 4, Inc 210 N Bolingbrook Dr Bolingbrook IL 60440-2386 Ph: (815) 310-3220  | Shining Smiles 4, Inc 110 N Larkin Ave Joliet IL 60435-6603 Ph: (630) 972-4010  | 
| NPI Number | 1922547264 | 
|---|---|
| Provider Enumeration Date | 02/20/2017 | 
| Last Update Date | 02/20/2017 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1922547264 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019028115 (Illinois) | Primary | 
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