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Organization
MAIN STREET DENTISTRY LLC
Active
Organization
MAIN STREET DENTISTRY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALAN M. ACIERNO DDS (CHIEF FINANCIAL OFFICER)
(630) 339-3172
Entity
Organization
Contact information
Practice address
801 MAIN STREET NW, BOURBONNAIS, IL 60914
(815) 932-3516
Mailing address
129 S. ROSELLE RD, STE. 102, SCHAUMBURG, IL 60193
(630) 339-3172
(847) 891-6775
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
07/17/2015
Last updated
09/15/2015
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