Myorthos Illinois Orthodontics PC

NPI #1194454454 in Ottawa, Illinois

Provider Information

NPI Number: 1194454454
Entity Type: Organization
Organization Name: Myorthos Illinois Orthodontics PC
Subpart: Yes (part of a larger organization)
Parent Organization: MYORTHOS ILLINOIS ORTHODONTICS PC
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Jun 9, 2022
Last Updated: Nov 20, 2024

Practice Location

Address: 1704 POLARIS CIR
City: Ottawa
State: Illinois
ZIP Code: 61350-1773
Phone: (815) 434-4222

Authorized Official

Name: CASEY LONABOCKER
Title: VP OPERATIONS & STRATEGY
Phone: (617) 535-3364

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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