Provider Demographics
NPI:1164641940
Name:OGUFERE, UNONMOSEN ENIOLA (DDS)
Entity Type:Individual
Prefix:DR
First Name:UNONMOSEN
Middle Name:ENIOLA
Last Name:OGUFERE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6695 GRAND AVE
Mailing Address - Street 2:SUITE E
Mailing Address - City:GURNEE
Mailing Address - State:IL
Mailing Address - Zip Code:60031-5268
Mailing Address - Country:US
Mailing Address - Phone:847-855-1445
Mailing Address - Fax:
Practice Address - Street 1:6695 GRAND AVE
Practice Address - Street 2:SUITE E
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-5268
Practice Address - Country:US
Practice Address - Phone:847-855-1445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL190265801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice