DR. David Dwight Domenella, DDS

NPI #1427217918 in Richmond, Illinois

Provider Information

NPI Number: 1427217918
Entity Type: Individual
Name: DR. David Dwight Domenella, DDS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: DDS
Enumeration Date: Jun 9, 2008
Last Updated: Oct 11, 2012

Practice Location

Address: 9716 US HIGHWAY 12
City: Richmond
State: Illinois
ZIP Code: 60071-9253
Phone: (815) 678-2800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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