Organization
MARIYA MANOVA DMD, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIYA I MANOVA DMD (PRESIDENT)
(501) 773-1233
Entity
Organization
Contact information
Practice address
2759 W 55TH ST, CHICAGO, IL 60632-2251
(501) 773-1233
Mailing address
215 W 59TH ST APT 20, HINSDALE, IL 60521-4928
(501) 773-1233
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019027529
IL
Other
Enumeration date
01/22/2009
Last updated
01/22/2009
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