SMILE ON OF NORTH SHORE PC NPI 1891264644

NPI Information

NPI: 1891264644
Provider Name: SMILE ON OF NORTH SHORE, PC
Classification: Durable Medical Equipment & Medical Supplies - 332BC3200X
Entity Type: Organization

Specialization: Customized Equipment

Address:
707 LAKE COOK RD.
SUITE 121
DEERFIELD, IL
ZIP 60015
Phone: (224) 282-8939
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SMILE ON OF NORTH SHORE, PC is a customized equipment durable medical equipment medical supplies in Deerfield, IL. SMILE ON OF NORTH SHORE, PC NPI is 1891264644. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

707 LAKE COOK RD.
SUITE 121
DEERFIELD, IL
ZIP 60015
Phone: (224) 282-8939
Fax: (773) 337-4988

The provider's authorized official is Paul Poncza .
The authorized official title is Owner and has the following contact phone number (224) 282-8939.

The enumeration date for this NPI number is 11/21/2018 and was last updated on 11/21/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice			No
2	332BC3200X	Durable Medical Equipment & Medical Supplies	Customized Equipment			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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