Provider Demographics
NPI:1710613666
Name:IDEAL SMILES BY FRANCISKA S. THEODOSIS DMD PLLC
Entity Type:Organization
Organization Name:IDEAL SMILES BY FRANCISKA S. THEODOSIS DMD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISKA
Authorized Official - Middle Name:
Authorized Official - Last Name:THEODOSIS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:847-253-5800
Mailing Address - Street 1:1880 OLYMPIC DR
Mailing Address - Street 2:
Mailing Address - City:VERNON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60061-4547
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3233 N ARLINGTON HEIGHTS RD STE 308
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1507
Practice Address - Country:US
Practice Address - Phone:847-253-5800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-25
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty