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DEBORAH FROGAMENI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
5215 N CALIFORNIA AVE, CHICAGO, IL 60625-7014
(312) 666-3494
(312) 666-6228
Mailing address
1701 W SUPERIOR ST, CHICAGO, IL 60622-5646
(312) 666-3494
(312) 666-6228

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-021744
IL
1223G0001X
General Practice Dentistry
30-018017
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
019021744
IL
01
10246
GROUP PARAMOUNT ID
OH
01
109100
DORAL DENTAL
OH
05
2219281
OH
01
600972
BUCKEYE GROUP ID
OH
05
8822331
OH
01
88333OH
DELTA DENTAL
OH
Enumeration date
06/30/2006
Last updated
11/21/2018
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