Provider Demographics
NPI:1770216624
Name:BEAUTY SMILE ORTHODONTICS 2 LLC
Entity Type:Organization
Organization Name:BEAUTY SMILE ORTHODONTICS 2 LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:ALAMIR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:331-318-8904
Mailing Address - Street 1:19622 S LA GRANGE RD
Mailing Address - Street 2:
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-9321
Mailing Address - Country:US
Mailing Address - Phone:331-318-8904
Mailing Address - Fax:708-995-1991
Practice Address - Street 1:19622 S LA GRANGE RD
Practice Address - Street 2:
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-9321
Practice Address - Country:US
Practice Address - Phone:331-318-8904
Practice Address - Fax:708-995-1991
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-07
Last Update Date:2022-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty