Applewhite Dental Illinois, P.c.

NPI #1982183943 in Freeport, Illinois

Provider Information

NPI Number: 1982183943
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: Aug 10, 2018
Last Updated: Jul 29, 2019

Practice Location

Address: 2661 W STEPHENSON ST
City: Freeport
State: Illinois
ZIP Code: 61032-4502
Phone: (563) 582-1448

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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