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Organization

JDM DDS PC

Active
Other names
JACK D MANIKOWSKI DDS PC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOHN D MANIKOWSKI DDS (PRESIDENT)
(312) 213-4179
Entity
Organization

Contact information

Practice address
6315 N MILWAUKEE AVE, CHICAGO, IL 60646-3760
(773) 774-1493
Mailing address
1701 N SHEFFIELD AVE STE 101, CHICAGO, IL 60614-5549
(312) 337-1665

Taxonomy

Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1710146964
NPI
Enumeration date
07/25/2022
Last updated
07/25/2022
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