Frederick P Waldschmidt D D S P C

NPI #1780758193 in Bourbonnais, Illinois

Provider Information

NPI Number: 1780758193
Entity Type: Organization
Organization Name: Frederick P Waldschmidt D D S P C
Primary Specialty: Dentist
Enumeration Date: Nov 17, 2006
Last Updated: Apr 21, 2015

Practice Location

Address: 750 ALMAR PARKWAY
Address 2: SUITE 101
City: Bourbonnais
State: Illinois
ZIP Code: 60914
Phone: (815) 932-5221

Authorized Official

Name: FREDERICK P WALDSCHMIDT, DDS
Title: PRESIDENT SECRETARY TREASURER
Phone: (815) 932-5221

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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