Rockfordctd LLC

NPI #1124795240 in Rockford, Illinois

Provider Information

NPI Number: 1124795240
Entity Type: Organization
Organization Name: Rockfordctd LLC
Primary Specialty: Dentist
Enumeration Date: Aug 26, 2021
Last Updated: Aug 26, 2021

Practice Location

Address: 1619 N ALPINE RD
City: Rockford
State: Illinois
ZIP Code: 61107-1414
Phone: (815) 229-3520

Authorized Official

Name: MITCH WEILAND
Title: ASSISTANT CONTROLLER
Phone: (608) 343-0818

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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