Organization
DENTPOL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ALICJA JONIK TECHNICIAN (PRESIDENT)
(773) 625-2626
Entity
Organization
Contact information
Practice address
7407 W IRVING PARK RD, CHICAGO, IL 60634-2139
(773) 625-2626
(773) 625-4071
Mailing address
7407 W IRVING PARK RD, CHICAGO, IL 60634-2139
(773) 625-2626
(773) 625-4071
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019015515
IL
Other
Enumeration date
02/01/2011
Last updated
02/01/2011
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