Rockford Dental Lounge INC

NPI #1932988458 in Rockford, Illinois

Provider Information

NPI Number: 1932988458
Entity Type: Organization
Organization Name: Rockford Dental Lounge INC
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Sep 25, 2023
Last Updated: Sep 25, 2023

Practice Location

Address: 4312 E STATE ST STE 1
City: Rockford
State: Illinois
ZIP Code: 61108-2144
Phone: (773) 865-2859

Authorized Official

Name: RABEH R SALAMAH-MOHAMMAD
Title: OWNER
Phone: (773) 543-6143

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Dental — Dental	261QD0000X	Primary

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