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100 Hansen Blvd North Aurora IL 60542-8985 | |
| (630) 896-3939 | |
| (630) 896-3997 |
| Full Name | |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 100 Hansen Blvd, North Aurora, Illinois |
| Authorized Official Name and Position | Hannah Fish (CREDENTIALING MANAGER) |
| Authorized Official Contact | 2175405699 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
100 Hansen Blvd North Aurora IL 60542-8985 Ph: (630) 896-3939 | 100 Hansen Blvd North Aurora IL 60542-8985 Ph: (630) 896-3939 |
| NPI Number | 1609053206 |
|---|---|
| Provider Enumeration Date | 01/25/2008 |
| Last Update Date | 07/31/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609053206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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