| St..charles Modern Dental Llc | |
|
855 S Randall Rd St Charles IL 60174-1570 | |
| (630) 587-2700 | |
| Not Available |
| Full Name | St..charles Modern Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 855 S Randall Rd, St Charles, Illinois |
| Authorized Official Name and Position | Jeff Thomas (PRESIDENT) |
| Authorized Official Contact | 6185324902 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St..charles Modern Dental Llc 855 S Randall Rd St Charles IL 60174-1570 Ph: (630) 587-2700 | St..charles Modern Dental Llc 855 S Randall Rd St Charles IL 60174-1570 Ph: (630) 587-2700 |
| NPI Number | 1134442304 |
|---|---|
| Provider Enumeration Date | 03/02/2010 |
| Last Update Date | 03/02/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134442304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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