Organization
VERSIANI DENTAL PC
Active
Other names
Blooming Smiles Chicago
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GABRIELA DURAES DDS (PRESIDENT)
(708) 834-3602
Entity
Organization
Contact information
Practice address
2340 N CALIFORNIA AVE, CHICAGO, IL 60647-6622
(708) 834-3602
Mailing address
156 E LAKE ST STE A, BLOOMINGDALE, IL 60108-1159
(630) 295-9600
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/13/2020
Last updated
07/13/2020
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