Provider Demographics
NPI:1437320652
Name:DEVON DENTAL SURGERY, LTD.
Entity Type:Organization
Organization Name:DEVON DENTAL SURGERY, LTD.
Other - Org Name:CHICAGO ORAL CARE, LTD.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/ DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NINA
Authorized Official - Middle Name:N
Authorized Official - Last Name:SANAI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:773-761-2521
Mailing Address - Street 1:1529 W DEVON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60660-1313
Mailing Address - Country:US
Mailing Address - Phone:773-761-2521
Mailing Address - Fax:773-761-2522
Practice Address - Street 1:1514 W DEVON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60660-1314
Practice Address - Country:US
Practice Address - Phone:773-761-2521
Practice Address - Fax:773-761-2522
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DEVON DENTAL SURGERY, LTD.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-03-15
Last Update Date:2016-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty