Organization
OS DENTAL LOUNGE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYUDMILA TAVOLZHANSKAYA DDS (DENTIST)
(314) 753-6005
Entity
Organization
Contact information
Practice address
5120 W IRVING PARK RD UNIT 1, CHICAGO, IL 60641-2624
(314) 753-6005
Mailing address
5120 W IRVING PARK RD UNIT 1, CHICAGO, IL 60641-2624
(314) 753-6005
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.027079
IL
Other
Enumeration date
04/02/2015
Last updated
04/02/2015
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