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
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 PracticeGeneral Practice

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