Pediatric Dentistry Ltd

NPI #1952454878 in Elgin, Illinois

Provider Information

NPI Number: 1952454878
Entity Type: Organization
Organization Name: Pediatric Dentistry Ltd
Primary Specialty: Clinic/Center - Dental
Enumeration Date: Jan 22, 2007
Last Updated: Aug 22, 2020

Practice Location

Address: 860 SUMMIT ST
Address 2: SUITE 246
City: Elgin
State: Illinois
ZIP Code: 60120-5145
Phone: (847) 695-1693

Authorized Official

Name: DR. DALE CHARLES NICKELSEN, D.D.S.
Title: PRESIDENT
Phone: (847) 695-1693

Specialties & Taxonomy Codes

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

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