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Organization
DENTAL CLUB ST. CHARLES P.C.
Active
Organization
DENTAL CLUB ST. CHARLES P.C.
Active
Other names
Dental Club St. Charles
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS J RYAN JR. DDS (PRESIDENT)
(708) 305-0729
Entity
Organization
Contact information
Practice address
3381 W MAIN ST STE 3, ST CHARLES, IL 60175-1008
(630) 513-2121
Mailing address
11310 POPLAR CREEK LN, ORLAND PARK, IL 60467-7308
(708) 305-0729
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
07/20/2022
Last updated
07/20/2022
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