Organization
PERIODONTAL ASSOCIATES, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER HOMOLA (OFFICE MANAGER)
(312) 751-1020
Entity
Organization
Contact information
Practice address
845 N MICHIGAN AVE STE 940W, CHICAGO, IL 60611-2216
(312) 751-1020
(312) 751-1231
Mailing address
845 N MICHIGAN AVE STE 940W, CHICAGO, IL 60611-2216
(312) 751-1020
(312) 751-1231
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Enumeration date
05/04/2018
Last updated
05/04/2018
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