| Modern Essence Dentistry | |
|
818 E Nerge Rd Roselle IL 60172-4884 | |
| (630) 582-0878 | |
| (630) 582-0898 |
| Full Name | Modern Essence Dentistry |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 818 E Nerge Rd, Roselle, Illinois |
| Authorized Official Name and Position | Brainard G. Llanes (PRESIDENT) |
| Authorized Official Contact | 3129532953 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Modern Essence Dentistry 818 E Nerge Rd Roselle IL 60172-4884 Ph: (630) 582-0878 | Modern Essence Dentistry 818 E Nerge Rd Roselle IL 60172-4884 Ph: (630) 582-0878 |
| NPI Number | 1285966671 |
|---|---|
| Provider Enumeration Date | 02/10/2010 |
| Last Update Date | 02/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285966671 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019.025966 (Illinois) | Primary |
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