Organization
MYS-ROSCOE LLC
Active
Other names
maintain your smile
Organization subpart
No
Provider details
NPI number
Authorized official
TODD STERN (OWNER)
(815) 398-3879
Entity
Organization
Contact information
Practice address
5416 REIMER DRIVE, ROSCOE, IL 61073
(815) 398-3879
Mailing address
1110 S MULFORD RD, ROCKFORD, IL 61108-4213
(815) 988-1993
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
09/17/2024
Last updated
09/17/2024
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