# CHILDREN'S DENTISTRY GROUP, LLC

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

## Provider details

- **NPI number:** 1497983688
- **Authorized official:** DR. PAUL DANA HERER D.M.D., M.S. (OWNER)
- **Authorized official phone:** (847) 726-0300

## Contact information

- **Practice address:** 195 S RAND RD, SUITE 110, LAKE ZURICH, IL 60047-2205
- **Practice address phone:** (847) 726-0300
- **Practice address fax:** (847) 726-3799
- **Mailing address:** 195 S RAND RD, SUITE 110, LAKE ZURICH, IL 60047-2205
- **Mailing address phone:** (847) 726-0300
- **Mailing address fax:** (847) 726-3799

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 019014868 | IL | Yes |

## Other

- **Enumeration date:** 06/25/2009
- **Last updated:** 06/25/2009