| Amber Dental Pc | |
|
319 E Roosevelt Rd Wheaton IL 60187-5526 | |
| (630) 665-5555 | |
| Not Available |
| Full Name | Amber Dental Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 319 E Roosevelt Rd, Wheaton, Illinois |
| Authorized Official Name and Position | Michael Koehne (PRESIDENT/DENTIST) |
| Authorized Official Contact | 6306655555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amber Dental Pc 319 E Roosevelt Rd Wheaton IL 60187-5526 Ph: (630) 665-5555 | Amber Dental Pc 319 E Roosevelt Rd Wheaton IL 60187-5526 Ph: (630) 665-5555 |
| NPI Number | 1790280758 |
|---|---|
| Provider Enumeration Date | 03/29/2018 |
| Last Update Date | 03/29/2018 |
| Medicare PECOS PAC ID | 6507193133 |
|---|---|
| Medicare Enrollment ID | O20190806000617 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790280758 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 019019448 (Illinois) | Primary |
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