Organization
FUENTESBURGOSSERVICECORPORATION
Active
Other names
Los Andes Dental and Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NUBIA E. FUENTES D.D.S. (PRESIDENT)
(630) 264-8042
Entity
Organization
Contact information
Practice address
205 CLARK ST, AURORA, IL 60505-4240
(630) 264-8042
(630) 264-8139
Mailing address
205 CLARK ST, AURORA, IL 60505-4240
(630) 264-8042
(630) 264-8139
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
IL
Other
Enumeration date
11/08/2006
Last updated
08/22/2020
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