Route 64 Dental LLC
NPI #1508384355 in St Charles, Illinois
Provider Information
- NPI Number
- 1508384355
- Entity Type
- Organization
- Organization Name
- Route 64 Dental LLC
- Primary Specialty
- Dentist - General Practice
- Enumeration Date
- Aug 31, 2017
- Last Updated
- Aug 31, 2017
Practice Location
- Address
- 306 W MAIN ST
- City
- St Charles
- State
- Illinois
- ZIP Code
- 60174-1814
- Phone
- (630) 584-6177
Authorized Official
- Name
- ALAN M ACIERNO
- Title
- CFO
- Phone
- (630) 339-3172
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dentist - General Practice — General Practice |
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