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Individual

DR. MICHAEL WILLIAM DONAHUE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS PC

Contact information

Practice address
15859 RIDGELAND AVE, SUITE A, OAK FOREST, IL 60452-2777
(708) 535-2828
Mailing address
15859 RIDGELAND AVE, SUITE A, OAK FOREST, IL 60452-2777
(708) 535-2828

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019018203
IL

Other

Enumeration date
07/29/2008
Last updated
07/29/2008
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