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Organization
ST. CHARLES FAMILY DENTRISTRY L.T.D.
Active
Organization
ST. CHARLES FAMILY DENTRISTRY L.T.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDMUND A LIPSKIS D.D.S. (OWNER)
(630) 377-3131
Entity
Organization
Contact information
Practice address
516 E MAIN ST, ST CHARLES, IL 60174-2133
(630) 377-3131
Mailing address
516 E MAIN ST, ST CHARLES, IL 60174-2133
(630) 377-3131
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0106X
Oral and Maxillofacial Pathology Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
207QS1201X
Sleep Medicine (Family Medicine) Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
Other
Enumeration date
02/09/2012
Last updated
02/09/2012
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