# REBECCA TESTA PEDIATRIC DENTAL SPECIALIST PLLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** REBECCA TESTA PEDIATRIC DENTISTRY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1326795782
- **Authorized official:** DR. REBECCA JANE TESTA DDS (OWNER)
- **Authorized official phone:** (708) 814-5783

## Contact information

- **Practice address:** 19815 GOVERNORS HWY STE 4, FLOSSMOOR, IL 60422-4388
- **Practice address phone:** (708) 799-5437
- **Practice address fax:** (708) 799-9373
- **Mailing address:** 19815 GOVERNORS HWY STE 4, FLOSSMOOR, IL 60422-4388
- **Mailing address phone:** (708) 799-5437
- **Mailing address fax:** (708) 799-9373

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | — | NULL | Yes |
| 1223P0221X | Pediatric Dentistry | — | — | Yes |

## Other

- **Enumeration date:** 03/06/2022
- **Last updated:** 03/06/2022