Provider Demographics
NPI:1881196582
Name:ALL PERFECT SMILES PC
Entity Type:Organization
Organization Name:ALL PERFECT SMILES PC
Other - Org Name:ALL PERFECT SMILES OF OAK FOREST
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:GEOVANNI
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MBA
Authorized Official - Phone:219-465-8627
Mailing Address - Street 1:6056 159TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60452-2904
Mailing Address - Country:US
Mailing Address - Phone:708-687-6100
Mailing Address - Fax:
Practice Address - Street 1:5950 159TH ST
Practice Address - Street 2:
Practice Address - City:OAK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60452-3164
Practice Address - Country:US
Practice Address - Phone:708-687-6100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-08
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019021104122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty