Organization
CELESTE L MEDYNSKYJ, DDS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CELESTE L MEDYNSKYJ DDS (CHIEF OFFICER)
(708) 453-0793
Entity
Organization
Contact information
Practice address
1600 W DEMPSTER ST, LL1, PARK RIDGE, IL 60068
(847) 699-4000
Mailing address
1830 N 74TH AVE, ELMWOOD PARK, IL 60707
(708) 453-0793
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019027913
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891921177
—
IL
Enumeration date
10/22/2010
Last updated
10/22/2010
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