Organization
DUBRAVEC PERIODONTAL SPECIALISTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOMINIK DUBRAVEC DDS, MMSC (OWNER)
(815) 464-3001
Entity
Organization
Contact information
Practice address
20635 ABBEY WOODS CT N STE 203, FRANKFORT, IL 60423-3186
(815) 464-3001
(815) 464-3010
Mailing address
20635 ABBEY WOODS CT N STE 203, FRANKFORT, IL 60423-3186
(815) 464-3001
(815) 464-3010
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1427122381
TYPE 1 NPI
IL
Enumeration date
07/29/2020
Last updated
12/16/2020
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