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Organization

SILVIO J CAMODECA DDS DN

Active
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Organization

SILVIO J CAMODECA DDS DN

Active
Other names
Avenue Dental Clinic & Lab
Organization subpart
No

Provider details

NPI number
Authorized official
DR. SILVIO J CAMODECA DDS DN (OWNER)
(773) 278-0334
Entity
Organization

Contact information

Practice address
3518 W FULLERTON AVE, CHICAGO, IL 60647
(773) 278-0334
(773) 365-0314
Mailing address
3518 W FULLERTON AVE, CHICAGO, IL 60647
(773) 278-0334
(773) 365-0314

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019015351
IL
122300000X
Dentist
12010C12A
IN
175F00000X
Naturopath
NAT1000255
DC
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
181000299
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
—
019015351
DENTISTRY
IL
01
—
12010612A
DENTISTRY
IN
01
—
181000299
NAPRAPATH
IL
01
—
NAT1000255
NATUROPATHY
DC
Enumeration date
01/04/2006
Last updated
08/30/2007
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