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Organization

MILLENNIUM DENTAL SPECIALIST

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CHRISTINE M GADIA DDS MS (OWNER/ DENTIST)
(312) 588-0112
Entity
Organization

Contact information

Practice address
1624 W DIVISION ST STE B, CHICAGO, IL 60622-3908
(773) 227-9000
(773) 227-9009
Mailing address
1624 W DIVISION ST STE B, CHICAGO, IL 60622-3908
(773) 227-9000
(773) 227-9009

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
019026871
IL
1223P0300X
Periodontics
Primary
019025900
IL

Other

Enumeration date
06/14/2018
Last updated
06/14/2018
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