Provider Demographics
NPI:1487086674
Name:ALL PERFECT SMILES
Entity type:Organization
Organization Name:ALL PERFECT SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LENA
Authorized Official - Middle Name:T
Authorized Official - Last Name:HALIKIAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-361-4300
Mailing Address - Street 1:13033 S LA GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:PALOS PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60464-1718
Mailing Address - Country:US
Mailing Address - Phone:708-361-4300
Mailing Address - Fax:708-361-4301
Practice Address - Street 1:13033 S LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-1718
Practice Address - Country:US
Practice Address - Phone:708-361-4300
Practice Address - Fax:708-361-4301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190211041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty