| Second Street Dental Llc | |
|
115 S 2nd St St Charles IL 60174-2812 | |
| (630) 339-3172 | |
| (847) 891-6775 |
| Full Name | Second Street Dental Llc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 115 S 2nd St, St Charles, Illinois |
| Authorized Official Name and Position | Alan J Acierno (OWNER) |
| Authorized Official Contact | 6303393172 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Second Street Dental Llc 129 S Roselle Rd Suite 102 Schaumburg IL 60193-5540 Ph: (630) 339-3172 | Second Street Dental Llc 115 S 2nd St St Charles IL 60174-2812 Ph: (630) 339-3172 |
| NPI Number | 1225478563 |
|---|---|
| Provider Enumeration Date | 07/01/2013 |
| Last Update Date | 07/01/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225478563 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (Illinois) | Primary |
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