DR. Jack Edgar Osterhaus, DDS

NPI #1427480177 in Lasalle, Illinois

Provider Information

NPI Number: 1427480177
Entity Type: Individual
Name: DR. Jack Edgar Osterhaus, DDS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - General Practice
Credential: DDS
Enumeration Date: Aug 5, 2013
Last Updated: Aug 5, 2013

Practice Location

Address: 2424 CHARTRES STREET
City: Lasalle
State: Illinois
ZIP Code: 61301-1107
Phone: (815) 223-6013

Specialties & Taxonomy Codes

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

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