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NPI Code Detail

MEDICARE: VAROUJAN DADOURIAN DDS

MEDICARE: VAROUJAN DADOURIAN DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistIL

General Provider Information

NPI Number : 1386835528
Entity Type Code : Individual
Provider Name (Legal Business Name) : VAROUJAN DADOURIAN DDS
Provider Business Mailing Address
First Line : 3143 W DEVON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-1424
Country : US
Telephone Number : 773-465-2922
Fax Number : 773-465-2998
Provider Business Practice Location Address
First Line : 3143 W DEVON AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60659-1424
Country : US
Telephone Number : 773-465-2922
Fax Number : 773-465-2998
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2007
Last Update Date : 08/05/2007

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Directions to “ VAROUJAN DADOURIAN DDS” Practice Location

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