Provider Demographics
NPI:1396062550
Name:SHERIF ALBERT DDS, PC
Entity type:Organization
Organization Name:SHERIF ALBERT DDS, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHERIF
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-493-0914
Mailing Address - Street 1:2001 BUTTERFIELD RD
Mailing Address - Street 2:SUITE 140
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-1050
Mailing Address - Country:US
Mailing Address - Phone:630-493-0914
Mailing Address - Fax:630-493-0917
Practice Address - Street 1:2001 BUTTERFIELD RD
Practice Address - Street 2:SUITE 140
Practice Address - City:DOWNERS GROVE
Practice Address - State:IL
Practice Address - Zip Code:60515-1050
Practice Address - Country:US
Practice Address - Phone:630-493-0914
Practice Address - Fax:630-493-0917
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-28
Last Update Date:2010-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019026818122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty