PRASAD B GONAVARUM

CHICAGO, IL
NPI1174512339
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy1223G0001X Dentist, General Practice
(Licence: IL  019026542)
Enumeration Date2005-10-19
Last Update Date2007-07-09
Business Address
-- PRASAD B GONAVARUM D.D.S.
2413 S STATE ST IDEAL DENTAL CENTER
CHICAGO, IL 60616-2311
Phone number: 312-528-1800
Mailing Address
-- PRASAD B GONAVARUM D.D.S.
7439 PIPERS WAY APT # 2
DOWNERS GROVE, IL 60516-4050
Phone number: 630-271-1687