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Organization

MILLENNIUM SURGICAL, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BARTLOMIEJ LECH NIERZWICKI MD, DMD, PHD, FACS (OWNER)
(773) 838-8855
Entity
Organization

Contact information

Practice address
5978 S ARCHER AVE, CHICAGO, IL 60638-2817
(773) 838-8855
(773) 796-3223
Mailing address
5978 S ARCHER AVE, CHICAGO, IL 60638-2817
(773) 838-8855
(773) 796-3223

Taxonomy

Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
021002267
IL

Other

Enumeration date
09/26/2012
Last updated
09/26/2012
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