| John M Domanico, D.d.s., P.c. | |
|
30 N Michigan Ave Suite522 Chicago IL 60602-3402 | |
| (312) 629-3530 | |
| (312) 629-3516 |
| Full Name | John M Domanico, D.d.s., P.c. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 30 N Michigan Ave, Chicago, Illinois |
| Authorized Official Name and Position | John M Domanico (OWNER) |
| Authorized Official Contact | 3126293530 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John M Domanico, D.d.s., P.c. 30 N Michigan Ave Suite522 Chicago IL 60602-3402 Ph: (312) 629-3530 | John M Domanico, D.d.s., P.c. 30 N Michigan Ave Suite522 Chicago IL 60602-3402 Ph: (312) 629-3530 |
| NPI Number | 1508262544 |
|---|---|
| Provider Enumeration Date | 11/18/2014 |
| Last Update Date | 11/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508262544 | NPI | - | NPPES |
| 1295840304 | Other | IL | NPPES.CMS.HHS.GOV |
| 1962500348 | Other | IL | NPPES.CMS.HHS.GOV |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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