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1053539981
DEBRA A GONG
CHICAGO, IL
NPI
1053539981
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: NC 8222)
Enumeration Date
2007-04-23
Last Update Date
2007-07-08
Business Address
Dr. DEBRA A GONG D.D.S.
820 S DAMEN AVE DENTAL SERVICE, JESSE BROWN VAMC
CHICAGO, IL 60612-3728
Phone number: 312-569-6669
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Mailing Address
Dr. DEBRA A GONG D.D.S.
3200 N LAKE SHORE DR #711
CHICAGO, IL 60657-3952
Phone number: 919-824-1748
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