Individual
DR. JOHN MICHAEL DOMANICO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
30 N MICHIGAN AVE, SUITE 522, CHICAGO, IL 60602-3402
(312) 629-3530
Mailing address
30 N MICHIGAN AVE, SUITE 522, CHICAGO, IL 60602-3402
(312) 629-3530
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
019018098
IL
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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