205 Direct Dental Services Inc.

NPI #1386525889 in Rockford, Illinois

Provider Information

NPI Number: 1386525889
Entity Type: Organization
Organization Name: 205 Direct Dental Services Inc.
Primary Specialty: Dentist
Enumeration Date: Sep 10, 2025
Last Updated: Sep 10, 2025

Practice Location

Address: 4151 SAMUELSON RD
City: Rockford
State: Illinois
ZIP Code: 61109-3272
Phone: (815) 637-6400

Authorized Official

Name: DR. HENRY CYRUS OATES, DDS
Title: DENTIST / PRESIDENT
Phone: (815) 637-6400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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