Individual
DR. DAVID DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
201 N CONSTITUTION DR # 1, AURORA, IL 60506-3214
(630) 896-4516
Mailing address
410 LAKEVIEW DR, AURORA, IL 60506-4444
(630) 715-5046
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019031489
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019031489
—
IL
Enumeration date
07/23/2017
Last updated
01/09/2019
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