Wheaton Prairie Dental LLC

NPI #1619322773 in Wheaton, Illinois

Provider Information

NPI Number
1619322773
Entity Type
Organization
Organization Name
Wheaton Prairie Dental LLC
Primary Specialty
Preferred Provider Organization
Enumeration Date
Apr 26, 2016
Last Updated
Apr 26, 2016

Practice Location

Address
610 W ROOSEVELT RD
Address 2
SUITE A1
ZIP Code
60187-5087
Phone
(630) 339-3172

Authorized Official

Name
ALAN J ACIERNO, DDS
Title
MANAGER
Phone
(630) 339-3172

Specialties & Taxonomy Codes

Specialty
Preferred Provider Organization

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