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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