Provider Demographics
NPI:1386056679
Name:SMILES ON WHEELS LLC
Entity type:Organization
Organization Name:SMILES ON WHEELS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AZAM
Authorized Official - Middle Name:
Authorized Official - Last Name:SAEED
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-400-7378
Mailing Address - Street 1:1263 S HIGHLAND AVE
Mailing Address - Street 2:SUITE 2E
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4516
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1263 S HIGHLAND AVE
Practice Address - Street 2:SUITE 2E
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4516
Practice Address - Country:US
Practice Address - Phone:630-400-7378
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental