Provider Demographics
NPI:1194567495
Name:DMB DENTAL, LTD
Entity type:Organization
Organization Name:DMB DENTAL, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRZOZOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:708-337-0928
Mailing Address - Street 1:5603 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2609
Mailing Address - Country:US
Mailing Address - Phone:630-241-3904
Mailing Address - Fax:
Practice Address - Street 1:5603 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:LISLE
Practice Address - State:IL
Practice Address - Zip Code:60532-2609
Practice Address - Country:US
Practice Address - Phone:630-241-3904
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty