| Ashbury Dental Clinic Inc | |
|
2272 W 95th St Suite 315 Naperville IL 60564-8912 | |
| (630) 717-0111 | |
| Not Available |
| Full Name | Ashbury Dental Clinic Inc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2272 W 95th St, Naperville, Illinois |
| Authorized Official Name and Position | Yong Taek Shim (PRESIDENT) |
| Authorized Official Contact | 6307170111 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ashbury Dental Clinic Inc 2272 W 95th St Suite 315 Naperville IL 60564-8912 Ph: (630) 717-0111 | Ashbury Dental Clinic Inc 2272 W 95th St Suite 315 Naperville IL 60564-8912 Ph: (630) 717-0111 |
| NPI Number | 1053568824 |
|---|---|
| Provider Enumeration Date | 08/25/2008 |
| Last Update Date | 01/15/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053568824 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019024865 (Illinois) | Primary |
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