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Organization
NAPERVILLE DENTAL GROUP
Active
Organization
NAPERVILLE DENTAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KENNETH R. PICKETT D.D.S. (PRESIDENT/BUSINESS OWNER)
(630) 527-0544
Entity
Organization
Contact information
Practice address
1020 E OGDEN AVE, SUITE 308, NAPERVILLE, IL 60563-8609
(630) 527-0544
(630) 527-2433
Mailing address
1020 E OGDEN AVE, SUITE 308, NAPERVILLE, IL 60563-8609
(630) 527-0544
(630) 527-2433
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
019.017904
IL
122300000X
Dentist
019.029826
IL
1223G0001X
General Practice Dentistry
Primary
019.017904
IL
1223G0001X
General Practice Dentistry
019.029826
IL
1223P0300X
Periodontics
021.001252
IL
Other
Enumeration date
03/09/2015
Last updated
03/09/2015
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