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Organization
MODERN ART OF DENTISTRY, INC
Active
Organization
MODERN ART OF DENTISTRY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KARINA LYON GAVRILOV DDS (OWNER)
(847) 465-0800
Entity
Organization
Contact information
Practice address
75 S MILWAUKEE AVE, WHEELING, IL 60090-3187
(847) 465-0800
(847) 465-0053
Mailing address
75 S MILWAUKEE AVE, WHEELING, IL 60090-3187
(847) 465-0800
(847) 465-0053
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
0019-024691
IL
Other
Enumeration date
10/23/2009
Last updated
10/23/2009
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