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1174512339
PRASAD B GONAVARUM
CHICAGO, IL
NPI
1174512339
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: IL 019026542)
Enumeration Date
2005-10-19
Last Update Date
2007-07-09
Business Address
-- PRASAD B GONAVARUM D.D.S.
2413 S STATE ST IDEAL DENTAL CENTER
CHICAGO, IL 60616-2311
Phone number: 312-528-1800
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Mailing Address
-- PRASAD B GONAVARUM D.D.S.
7439 PIPERS WAY APT # 2
DOWNERS GROVE, IL 60516-4050
Phone number: 630-271-1687
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