NPI 1578886206

Old Orchard Dental Group P.C.

Organisation Preferred Provider Organization Skokie, IL

Practice location

Address: 9631 Gross Point Rd Suite 4, Skokie, IL 60076-1264
Phone: (312) 402-7414

Authorised official

Name: Atosa Sarrafi
Title: President
Phone: (312) 402-7414

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X

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Registry record

NPI: 1578886206
Entity type: Organization
NPI issued: 9 Mar 2010
Record last updated: 9 Mar 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.