Organization
GERALD L WINE DDS AND DANIEL L LASSMAN DDS LTD
Active
Other names
Division Dental Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
NIDZA ALICEA (OFFICE MANAGER)
(773) 235-0990
Entity
Organization
Contact information
Practice address
2632 W DIVISION ST, CHICAGO, IL 60622-2950
(773) 235-0980
(773) 235-1249
Mailing address
2632 W DIVISION ST, CHICAGO, IL 60622-2950
(773) 235-0980
(773) 235-1249
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Enumeration date
02/02/2007
Last updated
07/16/2015
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