| Keith W Jaeschke Dds Pc | |
|
1545 Creek Dr Morris IL 60450-3004 | |
| (815) 942-0182 | |
| (815) 942-0966 |
| Full Name | Keith W Jaeschke Dds Pc |
|---|---|
| Speciality | Dentist |
| Location | 1545 Creek Dr, Morris, Illinois |
| Authorized Official Name and Position | Keith W Jaeschke (OWNER) |
| Authorized Official Contact | 8159420182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Keith W Jaeschke Dds Pc 1545 Creek Dr Morris IL 60450-3004 Ph: (815) 942-0182 | Keith W Jaeschke Dds Pc 1545 Creek Dr Morris IL 60450-3004 Ph: (815) 942-0182 |
| NPI Number | 1174837025 |
|---|---|
| Provider Enumeration Date | 08/03/2010 |
| Last Update Date | 08/03/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174837025 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 019.020128 (Illinois) | Secondary |
| 122300000X | Dentist | 019.016659 (Illinois) | Secondary |
| 122300000X | Dentist | 019.016384 (Illinois) | Primary |
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Dental Professionals Of Illinois, P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1010 W Us Route 6, Morris, IL 60450 Phone: 815-416-9257 | |
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Keith W. Jaeschke D.d.s., P.c. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1545 Creek Dr, Morris, IL 60450 Phone: 815-942-0182 |