| Aspen Dental | |
|
7310 Walton St Ste A Rockford IL 61108-4614 | |
| (866) 273-8204 | |
| (866) 803-4943 |
| Full Name | Aspen Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 7310 Walton St Ste A, Rockford, Illinois |
| Authorized Official Name and Position | Jerome Austriaco (OWNER) |
| Authorized Official Contact | 8662738204 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Aspen Dental Po Box 3189 Syracuse NY 13220-3189 Ph: (866) 273-8204 | Aspen Dental 7310 Walton St Ste A Rockford IL 61108-4614 Ph: (866) 273-8204 |
| NPI Number | 1750624110 |
|---|---|
| Provider Enumeration Date | 04/03/2013 |
| Last Update Date | 04/03/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750624110 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019021311 (Illinois) | Primary |
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