| Hanson & Sevandal Dentistry, Llc | |
| 
					2570 Foxfield Rd Ste 203 St Charles IL 60174-1406  | |
| (630) 587-4444 | |
| (630) 587-5811 | 
| Full Name | Hanson & Sevandal Dentistry, Llc | 
|---|---|
| Speciality | Dentist - Pediatric Dentistry | 
| Location | 2570 Foxfield Rd Ste 203, St Charles, Illinois | 
| Authorized Official Name and Position | Maureen Sevandal (MEMBER) | 
| Authorized Official Contact | 3124936102 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Hanson & Sevandal Dentistry, Llc 2570 Foxfield Rd Ste 203 St Charles IL 60174-1406 Ph: (630) 587-4444  | Hanson & Sevandal Dentistry, Llc 2570 Foxfield Rd Ste 203 St Charles IL 60174-1406 Ph: (630) 587-4444  | 
| NPI Number | 1366861296 | 
|---|---|
| Provider Enumeration Date | 04/08/2014 | 
| Last Update Date | 04/08/2014 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1366861296 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 019026649 (Illinois) | Secondary | 
| 1223P0221X | Dentist - Pediatric Dentistry | 019.026706 (Illinois) | Primary | 
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