| Ashley Family Dental, Ltd. | |
|
2504 Washington St Ste #503 Waukegan IL 60085-4983 | |
| (847) 244-0414 | |
| (847) 244-3104 |
| Full Name | Ashley Family Dental, Ltd. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 2504 Washington St, Waukegan, Illinois |
| Authorized Official Name and Position | Joo H Kwon (OWNER) |
| Authorized Official Contact | 8472440414 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Ashley Family Dental, Ltd. 2504 Washington St Ste #503 Waukegan IL 60085-4983 Ph: (847) 244-0414 | Ashley Family Dental, Ltd. 2504 Washington St Ste #503 Waukegan IL 60085-4983 Ph: (847) 244-0414 |
| NPI Number | 1669645958 |
|---|---|
| Provider Enumeration Date | 04/08/2008 |
| Last Update Date | 04/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669645958 | NPI | - | NPPES |
| 182486 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |
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