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Organization
UDELSON ELMHURST LLC
Active
Organization
UDELSON ELMHURST LLC
Active
Other names
Elmhurst Dentistry for Kids
Organization subpart
No
Provider details
NPI number
Authorized official
JERRY UDELSON DDS (OWNER)
(630) 833-1166
Entity
Organization
Contact information
Practice address
323 N YORK ST, ELMHURST, IL 60126-2319
(630) 833-1166
Mailing address
323 N YORK ST, ELMHURST, IL 60126-2319
(630) 833-1166
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
021001495
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
021001495
PEDIATRIC DENTISTRY
IL
Enumeration date
10/24/2017
Last updated
07/17/2024
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