| Shining Smiles LLC | |
|
210 N Bolingbrook Dr Bolingbrook IL 60440-2386 | |
| (312) 217-2223 | |
| Not Available |
| Full Name | Shining Smiles LLC |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 210 N Bolingbrook Dr, Bolingbrook, Illinois |
| Authorized Official Name and Position | Milad Nourahmadi Nourahmadi (PRESIDENT) |
| Authorized Official Contact | 3122172223 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shining Smiles LLC 208 N River Rd Naperville IL 60540-4040 Ph: (312) 217-2223 | Shining Smiles LLC 210 N Bolingbrook Dr Bolingbrook IL 60440-2386 Ph: (312) 217-2223 |
| NPI Number | 1972816650 |
|---|---|
| Provider Enumeration Date | 07/22/2010 |
| Last Update Date | 07/22/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972816650 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019028115 (Indiana) | Primary |
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