Meadow Lake Dental LLC

NPI #1972904282 in Aurora, Illinois

Provider Information

NPI Number
1972904282
Entity Type
Organization
Organization Name
Meadow Lake Dental LLC
Subpart
Yes (part of a larger organization)
Parent Organization
ACIERNO DENTAL, LLC
Primary Specialty
Preferred Provider Organization
Enumeration Date
Sep 7, 2014
Last Updated
Sep 7, 2014

Practice Location

Address
3941 75TH ST
Address 2
SUITE 102
City
Aurora
ZIP Code
60504-7924
Phone
(630) 851-5130

Authorized Official

Name
ALAN J ACIERNO, DDS
Title
MANAGER
Phone
(630) 339-3172

Specialties & Taxonomy Codes

Specialty
Preferred Provider Organization

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