# KIDS PLUS PEDIATRIC DENTISTRY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** KIDS PLUS PEDIATRIC DENTISTRY
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1780092437
- **Legal business name:** KIDS PLUS PEDIATRIC DENTISTRY
- **Authorized official:** DR. DENISE FISHER (PRESIDENT)
- **Authorized official phone:** (630) 243-6200

## Contact information

- **Practice address:** 15900 W 127TH ST, LEMONT, IL 60439-2910
- **Practice address phone:** (630) 243-6200
- **Practice address fax:** (630) 733-2448
- **Mailing address:** 15900 W 127TH ST, LEMONT, IL 60439-2910
- **Mailing address phone:** (630) 243-6200
- **Mailing address fax:** (630) 733-2448

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223P0221X | Pediatric Dentistry | 019023892 | IL | Yes |

## Other

- **Enumeration date:** 07/25/2014
- **Last updated:** 07/25/2014