Provider Demographics
NPI:1346615820
Name:ABSOLUTE DENTISTRY LTD
Entity Type:Organization
Organization Name:ABSOLUTE DENTISTRY LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISZA
Authorized Official - Middle Name:
Authorized Official - Last Name:AICH-RANJBARI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-804-9500
Mailing Address - Street 1:4911 W DIVERSEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-1705
Mailing Address - Country:US
Mailing Address - Phone:773-804-9500
Mailing Address - Fax:773-804-9501
Practice Address - Street 1:4911 W DIVERSEY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-1705
Practice Address - Country:US
Practice Address - Phone:773-804-9500
Practice Address - Fax:773-804-9501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL122300000XOtherTAXONOMY