Mefagui Dental Office P.c.

NPI #1134370059 in Chicago, Illinois

Provider Information

NPI Number: 1134370059
Entity Type: Organization
Organization Name: Mefagui Dental Office P.c.
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 9, 2008
Last Updated: Oct 9, 2008

Practice Location

Address: 6913 W. GRAND AVE
City: Chicago
State: Illinois
ZIP Code: 60707
Phone: (773) 622-4006

Authorized Official

Name: DR. ELSA GAMBOA, DDS
Title: PRESIDENT
Phone: (773) 622-4006

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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