Provider Demographics
NPI:1124629076
Name:ALIGN DENTAL GROUP PC.
Entity type:Organization
Organization Name:ALIGN DENTAL GROUP PC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMAD MOEIN
Authorized Official - Middle Name:
Authorized Official - Last Name:AZIMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-999-9637
Mailing Address - Street 1:2605 GRAND AVE STE A
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60085-2410
Mailing Address - Country:US
Mailing Address - Phone:847-244-7779
Mailing Address - Fax:847-244-7778
Practice Address - Street 1:2605 GRAND AVE STE A
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60085-2410
Practice Address - Country:US
Practice Address - Phone:847-244-7779
Practice Address - Fax:847-244-7778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty