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Organization
WOODLAWN DENTAL GALLERY
Active
Organization
WOODLAWN DENTAL GALLERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OGBONNA BANKOLE BOWDEN DDS (PRESIDENT)
(773) 793-1220
Entity
Organization
Contact information
Practice address
1502 E 63RD ST, CHICAGO, IL 60637-2921
(773) 496-5138
(773) 496-5142
Mailing address
8544 S STONY ISLAND AVE, CHICAGO, IL 60617-2248
(773) 221-0800
(773) 221-0868
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027749
IL
Other
Enumeration date
08/19/2015
Last updated
08/19/2015
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