Applewhite Dental Illinois, P.c.

NPI #1972157154 in Dixon, Illinois

Provider Information

NPI Number: 1972157154
Entity Type: Organization
Organization Name: Applewhite Dental Illinois, P.c.
Subpart: Yes (part of a larger organization)
Parent Organization: APPLEWHITE DENTAL ILLINOIS, P.C.
Primary Specialty: Dentist - General Practice
Enumeration Date: Jul 26, 2019
Last Updated: Jul 29, 2019

Practice Location

Address: 654 REYNOLDSWOOD RD
City: Dixon
State: Illinois
ZIP Code: 61021-9108
Phone: (815) 288-4028

Authorized Official

Name: SHARON L LOSO
Title: CREDENTIALING SPECIALIST
Phone: (563) 582-1448

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Dentist - General Practice — General Practice	1223G0001X	Primary

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