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Organization
WEST SIDE FAMILY DENTISTRY, LTD
Active
Organization
WEST SIDE FAMILY DENTISTRY, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERI LYNN SUNDBERG D.D.S. (DENTIST/PRESIDENT)
(815) 539-7004
Entity
Organization
Contact information
Practice address
709 PLAZA DR, MENDOTA, IL 61342-2457
(815) 539-7004
(815) 539-7060
Mailing address
709 PLAZA DR, MENDOTA, IL 61342-2457
(815) 539-7004
(815) 539-7060
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019-025531
IL
Other
Enumeration date
05/06/2015
Last updated
10/05/2022
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