| College Square Dental | |
|
6448 College Rd Lisle IL 60532-3290 | |
| (630) 983-8700 | |
| Not Available |
| Full Name | College Square Dental |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 6448 College Rd, Lisle, Illinois |
| Authorized Official Name and Position | Deann Derrico (BUSINESS ADMINISTRATOR) |
| Authorized Official Contact | 6309838700 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| College Square Dental 6448 College Rd Lisle IL 60532-3290 Ph: (630) 983-8700 | College Square Dental 6448 College Rd Lisle IL 60532-3290 Ph: (630) 983-8700 |
| NPI Number | 1760665442 |
|---|---|
| Provider Enumeration Date | 12/17/2007 |
| Last Update Date | 04/10/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760665442 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019-019814 (Illinois) | Primary |
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