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Organization
JOHN M DOMANICO, D.D.S., P.C.
Active
Organization
JOHN M DOMANICO, D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN M DOMANICO D.D.S. (OWNER)
(312) 629-3530
Entity
Organization
Contact information
Practice address
30 N MICHIGAN AVE, SUITE522, CHICAGO, IL 60602-3402
(312) 629-3530
(312) 629-3516
Mailing address
30 N MICHIGAN AVE, SUITE522, CHICAGO, IL 60602-3402
(312) 629-3530
(312) 629-3516
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
11/18/2014
Last updated
11/18/2014
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