Paul Buenvenida
Dentist in Chicago, IL. Individual provider (NPI-1).
NPI number1760638159
StatusActive
Last updated in NPPESMay 3, 2021
Details
- NPI
- 1760638159
- Entity type
- Individual (NPI-1)
- Name
- Paul Buenvenida
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Aug 18, 2008
- Certification date
- May 3, 2021
- Last updated
- May 3, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 019023430 | IL | Yes |
Practice location
55 E Washington St3001
Chicago, IL 60602-2103
Phone 312-407-9900
Mailing address
3750 N Lake Shore Dr Apt 13cChicago, IL 60613-4229
Phone 708-400-2169
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