Provider Demographics
NPI:1982257218
Name:ALLURE DENTAL LINCOLN PARK
Entity Type:Organization
Organization Name:ALLURE DENTAL LINCOLN PARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DDS/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ATTA
Authorized Official - Middle Name:
Authorized Official - Last Name:BABER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-565-0014
Mailing Address - Street 1:558 W DIVERSEY PKWY
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1678
Mailing Address - Country:US
Mailing Address - Phone:312-565-0014
Mailing Address - Fax:
Practice Address - Street 1:558 W DIVERSEY PKWY
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-1678
Practice Address - Country:US
Practice Address - Phone:312-565-0014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-07-16
Last Update Date:2019-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental