Organization
BRUSHIN' ON BELMONT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT GOVONI DDS (OWNER)
(773) 281-9800
Entity
Organization
Contact information
Practice address
2007 W BELMONT AVE, CHICAGO, IL 60618-6792
(773) 281-9800
Mailing address
2007 W BELMONT AVE, CHICAGO, IL 60618-6792
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
019026662
IL
1223P0221X
Pediatric Dentistry
021002151
IL
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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