Organization
GINA L. TAMBORNINI DDS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GINA LYN TAMBORNINI D.D.S. (DENTIST/PRESIDENT)
(312) 642-4218
Entity
Organization
Contact information
Practice address
1640 N WELLS ST., SUITE 205, CHICAGO, IL 60614-6006
(312) 642-4218
(312) 642-6419
Mailing address
1640 N WELLS ST., SUITE 205, CHICAGO, IL 60614-6006
(312) 642-4218
(312) 642-6419
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019203206
IL
Other
Enumeration date
08/11/2008
Last updated
07/17/2012
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