Individual
RODA JEAN MENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
5225 TOUHY AVE, SKOKIE, IL 60077-3245
(847) 807-7341
Mailing address
555 W KINZIE ST APT 2512, CHICAGO, IL 60654-5856
(651) 734-5107
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019.033763
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2022
Last updated
06/16/2022
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