Organization
MAJOR DENTAL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AGNIESZKA DOMAGALA D.D.S. (PRESIDENT)
(773) 777-1111
Entity
Organization
Contact information
Practice address
3208 N MAJOR AVE, CHICAGO, IL 60634-4332
(773) 777-1111
(773) 777-0730
Mailing address
3208 N MAJOR AVE, CHICAGO, IL 60634-4332
(773) 777-1111
(773) 777-0730
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019027819
IL
Other
Enumeration date
06/11/2009
Last updated
06/11/2009
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