Organization
PAUL PONCZA DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL PONCZA DDS (PRESIDENT)
(773) 525-5545
Entity
Organization
Contact information
Practice address
1350 W BELMONT AVE, SUITE 1, CHICAGO, IL 60657-3245
(773) 525-5545
(773) 337-4988
Mailing address
1350 W BELMONT AVE, SUITE 1, CHICAGO, IL 60657-3245
(773) 525-5545
(773) 337-4988
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
019026404
IL
Other
Enumeration date
06/24/2011
Last updated
06/24/2011
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