| Floss Dental Studio PC | |
|
924 N Damen Ave Chicago IL 60622-4948 | |
| (773) 235-2322 | |
| (773) 235-2332 |
| Full Name | Floss Dental Studio PC |
|---|---|
| Speciality | Dentist |
| Location | 924 N Damen Ave, Chicago, Illinois |
| Authorized Official Name and Position | Michelle Ann Radeka (OWNER/PRES/DENTIST) |
| Authorized Official Contact | 7732352322 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Floss Dental Studio PC Po Box 221018 Chicago IL 60622-0008 Ph: (773) 235-2322 | Floss Dental Studio PC 924 N Damen Ave Chicago IL 60622-4948 Ph: (773) 235-2322 |
| NPI Number | 1851785224 |
|---|---|
| Provider Enumeration Date | 03/24/2015 |
| Last Update Date | 04/23/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851785224 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019025071 (Illinois) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | () | Secondary |
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