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Organization

JULIA R. PESAVENTO, D.M.D.

Active
Parent organization
JULIA R. PESAVENTO, D.M.D.
Other names
Katherine F. Stewart, D.D.S.
Organization subpart
Yes

Provider details

NPI number
Legal business name
JULIA R. PESAVENTO, D.M.D.
Authorized official
DR. JULIA REGINA PESAVENTO D.M.D. (OWNER)
(815) 395-1711
Entity
Organization

Contact information

Practice address
1075 FEATHERSTONE RD, SUITE 30, ROCKFORD, IL 61107-5906
(815) 395-1711
(815) 395-1705
Mailing address
1075 FEATHERSTONE RD, SUITE 30, ROCKFORD, IL 61107-5906
(815) 395-1711
(815) 395-1705

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
IL

Other

Enumeration date
11/06/2008
Last updated
11/06/2008
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