Organization
GLAMOUR DENTAL CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MONIKA TYSZKOWSKI (PRESIDENT)
(773) 736-6610
Entity
Organization
Contact information
Practice address
6825 W ADDISON ST, CHICAGO, IL 60634-3702
(773) 736-6610
(773) 736-6614
Mailing address
6825 W ADDISON ST, CHICAGO, IL 60634-3702
(773) 736-6610
(773) 736-6614
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019025140
IL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
019025140
IL
Other
Enumeration date
12/04/2014
Last updated
12/04/2014
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