# WOODSTOCK DENTAL ASSOCIATES, LTD.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1144643966
- **Authorized official:** DR. CHUNGYOON HA DDS (ASSOCIATE)
- **Authorized official phone:** (815) 338-1138

## Contact information

- **Practice address:** 666 W JACKSON ST STE B, WOODSTOCK, IL 60098-3198
- **Practice address phone:** (815) 338-1138
- **Practice address fax:** (815) 338-3910
- **Mailing address:** 666 W JACKSON ST STE B, WOODSTOCK, IL 60098-3198
- **Mailing address phone:** (815) 338-1138
- **Mailing address fax:** (815) 338-3910

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 302F00000X | Exclusive Provider Organization | 019025426 | IL | Yes |

## Other

- **Enumeration date:** 01/30/2014
- **Last updated:** 01/30/2014