Organization
WESTERN DENTAL GROUP PC
Active
Parent organization
NO
Organization subpart
Yes
Provider details
NPI number
Legal business name
NO
Authorized official
SIMONA LILIANA KATONA (DENTIST/OWNER)
(312) 502-8073
Entity
Organization
Contact information
Practice address
3935 N WESTERN AVE, SUITE 1S, CHICAGO, IL 60618-3761
(773) 588-1141
(773) 588-1143
Mailing address
3935 N WESTERN AVE, SUITE 1S, CHICAGO, IL 60618-3761
(773) 588-1141
(773) 588-1143
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
021002372
IL
Other
Enumeration date
03/26/2014
Last updated
03/26/2014
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