Provider Demographics
NPI:1043336621
Name:SIGNATURE SMILES DENTAL CARE LTD
Entity type:Organization
Organization Name:SIGNATURE SMILES DENTAL CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:708-386-6190
Mailing Address - Street 1:1128 LAKE STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60301-1058
Mailing Address - Country:US
Mailing Address - Phone:708-386-6190
Mailing Address - Fax:708-386-3047
Practice Address - Street 1:1128 LAKE STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60301-1058
Practice Address - Country:US
Practice Address - Phone:708-386-6190
Practice Address - Fax:708-386-3047
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty