Organization
KRYSTYNA WAGENHEJM CIESIELSKI DDS PC
Active
Other names
OMDENT
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRYSTYNA WAGENEHJM-CIESIELSKI DDS (PRESIDENT)
(847) 581-9400
Entity
Organization
Contact information
Practice address
7900 N MILWAUKEE AVE, STE 2-21B, NILES, IL 60714-3159
(847) 581-9400
(847) 581-9044
Mailing address
7900 N MILWAUKEE AVE, STE 2-21B, NILES, IL 60714-3159
(847) 581-9400
(847) 581-9044
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019024460
IL
1223E0200X
Endodontics
021002182
IL
1223P0300X
Periodontics
021001519
IL
Other
Enumeration date
11/15/2006
Last updated
07/03/2008
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