Organization
FULL DENTAL PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON FULL (MANAGER)
(815) 477-4055
Entity
Organization
Contact information
Practice address
615 DAKOTA ST STE A, CRYSTAL LAKE, IL 60012-3732
(815) 477-4055
Mailing address
615 DAKOTA ST STE A, CRYSTAL LAKE, IL 60012-3732
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
03/03/2025
Last updated
03/03/2025
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