Individual
NIEKLA SURVIA ANDIESTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
801 S PAULINA ST, CHICAGO, IL 60612-7210
(312) 355-1712
Mailing address
801 S PAULINA ST, CHICAGO, IL 60612-7210
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
136.000284
IL
Other
Enumeration date
06/03/2026
Last updated
06/03/2026
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