Organization
LINCOLN COSMETIC DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHERINE GERGINIS (OWNER)
(773) 878-3168
Entity
Organization
Contact information
Practice address
5962 N LINCOLN AVE STE 10, CHICAGO, IL 60659-3762
(773) 878-3168
(773) 878-3317
Mailing address
5962 N LINCOLN AVE STE 10, CHICAGO, IL 60659-3762
(773) 878-3168
(773) 878-3317
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019016806
IL
Other
Enumeration date
02/02/2013
Last updated
02/02/2013
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