Organization
AMI G VAIDYA DMD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMI VAIDYA DMD (DENTIST)
(773) 533-4323
Entity
Organization
Contact information
Practice address
3900 W MADISON ST, SUITE 12, CHICAGO, IL 60624-2354
(773) 533-4323
Mailing address
3900 W MADISON ST, SUITE 12, CHICAGO, IL 60624-2354
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019027900
IL
Other
Enumeration date
08/16/2011
Last updated
08/16/2011
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