| NPI | 1740268416 |
|---|---|
| Doing Business As | AVENUE DENTAL CLINIC & LAB |
| Entity Type | Organization |
| Authorized Contact | SILVIO J CAMODECA Owner 773-278-0334 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist (Licence: IL 019015351) |
| Additional Taxonomies | 122300000X Dentist (Licence: IN 12010C12A) |
| 175F00000X Naturopath (Licence: DC NAT1000255) | |
| 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: IL 181000299) | |
| Enumeration Date | 2006-01-04 |
| Last Update Date | 2007-08-30 |