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Organization
DENTAL LOFT KIDS LLC
Active
Organization
DENTAL LOFT KIDS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KILEY HIRONS DDS (CO-OWNER)
(708) 482-0702
Entity
Organization
Contact information
Practice address
1 W HARRIS AVE STE 2A, LA GRANGE, IL 60525-2497
(708) 482-0702
Mailing address
1 W HARRIS AVE STE 2A, LA GRANGE, IL 60525-2497
(708) 482-0702
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
—
NULL
1223P0221X
Pediatric Dentistry
Primary
—
—
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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