| Smiles Of Elgin P.c | |
|
860 Summit St Suite 134 Elgin IL 60120-5145 | |
| (847) 695-3368 | |
| (847) 695-3351 |
| Full Name | Smiles Of Elgin P.c |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 860 Summit St, Elgin, Illinois |
| Authorized Official Name and Position | Prasad Gonavarum (OWNER) |
| Authorized Official Contact | 8476953368 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Smiles Of Elgin P.c 860 Summit St Suite 134 Elgin IL 60120-5145 Ph: (847) 695-3368 | Smiles Of Elgin P.c 860 Summit St Suite 134 Elgin IL 60120-5145 Ph: (847) 695-3368 |
| NPI Number | 1114296712 |
|---|---|
| Provider Enumeration Date | 12/28/2011 |
| Last Update Date | 12/28/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114296712 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019019439 (Illinois) | Primary |
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