Organization
ATHENA DENTAL INSTITUTE P C
Active
Other names
Athena Dental Group of Chicago
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREA MILLER-FINCH DDS (PRESIDENT)
(773) 235-2000
Entity
Organization
Contact information
Practice address
1621 W NORTH AVE, UNIT C-1, CHICAGO, IL 60622-2328
(773) 235-2000
Mailing address
1621 W NORTH AVE, UNIT C-1, CHICAGO, IL 60622-2328
(773) 235-2000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019022059
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1002966
—
IL
Enumeration date
04/03/2017
Last updated
04/03/2017
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