Irina Bolotnikov DDS PC

NPI #1740326313 in Morton Grove, Illinois

Provider Information

NPI Number: 1740326313
Entity Type: Organization
Organization Name: Irina Bolotnikov DDS PC
Primary Specialty: Dentist - General Practice
Enumeration Date: Jan 30, 2007
Last Updated: Jun 18, 2008

Practice Location

Address: 7963 GOLD ROAD
City: Morton Grove
State: Illinois
ZIP Code: 60053
Phone: (847) 583-0033

Authorized Official

Name: IRINA BOLOTNIKOV, DDS
Title: DENTIST PRESIDENT
Phone: (847) 583-0033

Specialties & Taxonomy Codes

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

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