Julia R. Pesavento, D.m.d.

NPI #1083868806 in Rockford, Illinois

Provider Information

NPI Number: 1083868806
Entity Type: Organization
Organization Name: Julia R. Pesavento, D.m.d.
Subpart: Yes (part of a larger organization)
Parent Organization: JULIA R. PESAVENTO, D.M.D.
Primary Specialty: Dentist - General Practice
Enumeration Date: Nov 6, 2008
Last Updated: Nov 6, 2008

Practice Location

Address: 1075 FEATHERSTONE RD
Address 2: SUITE 30
City: Rockford
State: Illinois
ZIP Code: 61107-5906
Phone: (815) 395-1711

Authorized Official

Name: DR. JULIA REGINA PESAVENTO, D.M.D.
Title: OWNER
Phone: (815) 395-1711

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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