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Organization
PRESIDENTIAL DENTAL
Active
Organization
PRESIDENTIAL DENTAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PETER A MICHALAK DDS (DENTIST)
(312) 902-3131
Entity
Organization
Contact information
Practice address
564 W WASHINGTON BLVD, CHICAGO, IL 60661-2509
(312) 902-3131
Mailing address
564 W WASHINGTON BLVD, CHICAGO, IL 60661-2509
(312) 902-3131
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
08/14/2007
Last updated
01/28/2014
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