| Innovative Orthodontic Centers | |
|
55 S Main St Ste 271 Naperville IL 60540-8044 | |
| (630) 848-6960 | |
| Not Available |
| Full Name | Innovative Orthodontic Centers |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 55 S Main St Ste 271, Naperville, Illinois |
| Authorized Official Name and Position | Tabatha Lemke (CREDENTIALING COORDINATOR) |
| Authorized Official Contact | 2175406078 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Innovative Orthodontic Centers 55 S Main St Ste 271 Naperville IL 60540-8044 Ph: () - | Innovative Orthodontic Centers 55 S Main St Ste 271 Naperville IL 60540-8044 Ph: (630) 848-6960 |
| NPI Number | 1568046969 |
|---|---|
| Provider Enumeration Date | 05/11/2021 |
| Last Update Date | 06/04/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568046969 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Secondary |
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | (* (Not Available)) | Primary |
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