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Individual

DR. NADINE BRODALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS, MS, DMD

Contact information

Practice address
25 E WASHINGTON ST, 1125, CHICAGO, IL 60602-1708
(312) 641-2572
Mailing address
25 E WASHINGTON ST, 1125, CHICAGO, IL 60602-1708
(312) 641-2572

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019028809
IL
1223P0300X
Periodontics
0048
NC
1223P0300X
Periodontics
DE9503
WA

Other

Enumeration date
01/08/2007
Last updated
08/19/2011
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