# THE TRAVELING TOOTH FAIRY

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

## Provider details

- **NPI number:** 1679304521
- **Authorized official:** JEANNE BRYANT (GENERAL MANAGER)
- **Authorized official phone:** (630) 738-1019

## Contact information

- **Practice address:** 1212 S. NAPER BLVD., STE. \#119/177, NAPERVILLE, IL 60540
- **Practice address phone:** (312) 391-3385
- **Mailing address:** 1212 S. NAPER BLVD., STE. \#119/177, NAPERVILLE, IL 60540
- **Mailing address phone:** (630) 738-1019

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 251K00000X | Public Health or Welfare Agency | — | NULL | Yes |

## Other

- **Enumeration date:** 08/12/2024
- **Last updated:** 08/12/2024