Mys - Rockford LLC

NPI #1952771636 in Rockford, Illinois

Provider Information

NPI Number: 1952771636
Entity Type: Organization
Organization Name: Mys - Rockford LLC
Primary Specialty: Dentist - General Practice
Enumeration Date: Oct 6, 2015
Last Updated: Jun 19, 2017

Practice Location

Address: 1110 S MULFORD RD
City: Rockford
State: Illinois
ZIP Code: 61108-4213
Phone: (815) 398-3879

Authorized Official

Name: TODD STERN, D.D.S
Title: OWNER
Phone: (815) 398-2879

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary
Clinic/Center - Dental — Dental	261QD0000X

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