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Organization
THE LOOSE TOOTH PEDIATRIC DENTISTRY
Active
Organization
THE LOOSE TOOTH PEDIATRIC DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RHIANNON MICHELLE HOLCOMBE DDS, MS (PEDIATRIC DENTIST)
(815) 267-7299
Entity
Organization
Contact information
Practice address
15041 S VAN DYKE RD, SUITE 105, PLAINFIELD, IL 60544-5805
(815) 267-7299
Mailing address
15041 S VAN DYKE RD, SUITE 105, PLAINFIELD, IL 60544-5805
(815) 267-7299
(815) 267-7511
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
019027249
IL
Other
Enumeration date
01/06/2014
Last updated
03/24/2015
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