Portage Park Dental Associates, Ltd

NPI #1003124371 in Chicago, Illinois

Provider Information

NPI Number: 1003124371
Entity Type: Organization
Organization Name: Portage Park Dental Associates, Ltd
Primary Specialty: Dentist
Enumeration Date: Sep 20, 2010
Last Updated: Sep 20, 2010

Practice Location

Address: 5613 W IRVING PARK RD
City: Chicago
State: Illinois
ZIP Code: 60634-2740
Phone: (773) 286-4030

Authorized Official

Name: DR. ANETA CHOMA-DLOUCHY, DDS
Title: PRESIDENT
Phone: (773) 286-4030

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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