Individual
DR. DANIEL MICHAL DOMAGALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.S.
Contact information
Practice address
3208 N. MAJOR AVENUE, CHICAGO, IL 60634
(773) 777-1111
(773) 777-0730
Mailing address
3208 N. MAJOR AVENUE, CHICAGO, IL 60634
(773) 777-1111
(773) 777-0730
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.027866
IL
122300000X
Dentist
6468115
WI
1223P0700X
Prosthodontics
019027866
IL
Other
Enumeration date
02/04/2009
Last updated
09/13/2010
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