Organization
ABC DENTISTRY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER ANN REYES (OFFICE MANAGER)
(847) 882-3360
Entity
Organization
Contact information
Practice address
80 W HILLCREST BLVD STE 212, SCHAUMBURG, IL 60195
(847) 882-3360
(847) 882-3383
Mailing address
80 W HILLCREST BLVD STE 212, SCHAUMBURG, IL 60195-3111
(847) 882-3360
(847) 882-3383
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
019.021872
IL
1223P0221X
Pediatric Dentistry
019.015237
IL
1223P0221X
Pediatric Dentistry
Primary
019.021868
IL
1223P0221X
Pediatric Dentistry
019.023646
IL
1223P0221X
Pediatric Dentistry
019.025711
IL
1223P0221X
Pediatric Dentistry
019.026464
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019.021868
—
IL
Enumeration date
02/13/2007
Last updated
06/27/2018
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